Myelography Radiology Billing
New coding, compliance, and reimbursement changes and challenges are the ones that are seen in 2015 for Radiology billing and coding. There were some changes made to the CPT code book sections for radiology as well:
Myelography
Two myelogram injection codes have been revised and four new comprehensive codes have been introduced for myelogram contrast injection and imaging.
For the injection codes, the description of 61055 has been changed and the words C1-C2 have been removed. Also, the description of 62284 has changed from “Injection-spinal” to “Injection-lumbar.”
The new comprehensive codes include the lumbar injection as well as the myelogram supervision and interpretation. The existing myelogram imaging codes (72240-72270) have not been deleted for 2015. Different physicians perform the injection and the imaging guidance in given situation, therefore these codes have been retained. A comprehensive code, and not the component codes, would be submitted,
if a physician performs the entire procedure. To summarize, myelography should not be reported solely for the documentation of needle placement; a complete procedure with full imaging must be performed and documented, as has previously been the case. However, ?the supervision and interpretation for myelography should not be reported without the referring physician or other qualified health care professional requesting an X-ray myelogram.” Appending modifier 59 to the CT of the spine if it is performed on the same day as a traditional X-ray myelogram is recommended.
Vertebroplasty, Vertebral Augmentation, Sacroplasty
Three new codes have been established instead of the previous vertebroplasty codes (22520-22522) . Since these codes include all imaging guidance, so the supervision and interpretation codes 72291 and 72292 have also been deleted. CPT(R) now provides codes for cervicothoracic (22510) and lumbosacral (22511) procedures and an additional code(+22512) for reporting the codes, instead of codes for thoracic and lumbar vertebroplasty. Bone biopsy is included in all of the vertebroplasty, kyphoplasty, and sacroplasty codes when performed at the same level.
Three new codes have been established and includes all the imaging guidance associated with the procedure, 22513,22514 and +22515.
The Category III sacroplasty codes (0200T-0201T) have imaging guidance and bone biopsy included when performed.
Bone Xray studies:
Vertebral fracture assessment (VFA): The Vertebral Fracture Assessment code (77082) has been deleted, and two new Vertebral Fracture Assessment codes (77085-77086) have been created.
- Code 77085 is a combination code that includes axial dual-energy X-ray absorptiometry (DXA) as well as Vertebral Fracture Assessment, while
- 77086 is a stand-alone Vertebral Fracture Assessment. The existing codes for axial and appendicular DXA studies (77080, 77081) have not changed and will be used whenever DXA is performed without Vertebral Fracture Assessment.
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