AMA Clinical Examples in Radiology - 2007 Issue 4 (Fall)
Radiology FAQ
Radiology FAQ If you have a question you would like to see addressed in the newsletter, please e-mail clinex@acr.org. The editorial staff will pick the most frequently asked questions for publication. Question: Answer: Our practice is considering implementing a computer-aided detection software system for our breast sonography services. How should this service be reported? Note CPT code 99211 is reserved for an established patient. The 2007 CPT codebook differentiates between new and established patients: "A new patient is one who has not received any professional services from the physician or another physician of the same specialty who belongs...
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Article Overview
This article collects frequently asked radiology coding questions and discusses how to recognize and report several common imaging and nuclear medicine services under CPT and related Medicare/CLIA guidance. It is useful for radiologists, coders, and billing staff who need a broad overview of coding topics spanning diagnostic ultrasound, vascular studies, fluoroscopic procedures, advanced imaging, and laboratory-based nuclear medicine tests.
Why This Topic Matters
Radiology practices often face coding questions that cross imaging modalities and payment systems. This FAQ helps readers identify the relevant service categories, understand which code families are implicated, and recognize when documentation or setting affects reporting.
Article Sections
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Ultrasound CAD for breast sonography
Addresses coding considerations for breast ultrasound services when computer-aided detection software is involved. Also touches on related evaluation and management coding concerns raised in the question.
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Duplex scan of extracranial arteries
Discusses reporting of extracranial arterial duplex studies when one side is not fully measurable or when vascular structures are documented differently than expected. Also references Doppler-related guidance in the CPT diagnostic ultrasound section.
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Hip arthrography with local anesthetic
Covers coding for hip arthrography injection services, associated radiologic supervision and interpretation, and anesthesia reporting in a procedural setting.
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Three-dimensional postprocessing terminology
Explains what report language coders may look for when determining whether 3D postprocessing was performed. It also notes the importance of documenting the workstation context.
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CT colonography after incomplete colonoscopy
Reviews how the indication for CT colonography may relate to the type of colonoscopy that was attempted and what was encountered during the procedure. The discussion distinguishes screening and diagnostic contexts.
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PET/CT on hybrid scanners
Discusses technical and professional component reporting when PET/CT is performed on a hybrid scanner. It also addresses when additional diagnostic CT reporting may be appropriate.
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Urea breath testing and Medicare payment
Explains how urea breath test services are categorized within CPT and how payment is handled under Medicare and laboratory-related requirements. The section also mentions CLIA certification.
What You Will Learn
- Which general imaging and nuclear medicine services are addressed in the FAQ
- How radiology documentation issues can affect code selection and reporting
- What broad kinds of CPT guidance are discussed for ultrasound, vascular, PET/CT, and arthrography services
- How laboratory-based nuclear medicine tests differ from physician fee schedule services
- What documentation terms may indicate 3D postprocessing
- How screening versus diagnostic context is handled in colonography scenarios
Who Should Read This
- Radiologists
- Radiology coders
- Medical billers
- Radiology practice managers
- Hospital coding staff
Codes Discussed
Code Ranges Discussed
Modifiers Discussed
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