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  • 1.  Comparative imaging study

    Posted 10-26-2020 08:23
    Dear Forum,

    I went through the archives and found a lot of previous Q&A about the comparative imaging studies that can not be billed according to CCI.
    Our group (pro billing)  is looking at this very hard and I need to clarify a couple of things.

    1: post reduction xrays - example: patient in ER with broken wrist identified by x-ray (billable pro side).  Then after the ER doc sets the fracture a Post Reduction x-ray is done. (Not billable for Pro side but ok for Tech).  I saw different answers in the forum post about this.
    One person said since the radiologist did not reduce the fracture themselves, they can bill the post reduction. Others said Post reduction x-rays can not be billed on the pro side period.    Which is correct?

    2: when our docs do the post cath placement chest xrays, we do not bill the follow up chest xray; however if an xray is ordered later in the day to re-check placement we do with a -52 modifier.  And they usually are also commenting on the findings, lots of effusions, PNA... etc...   Is this OK?

    Thank you for your help,




    ​

    ------------------------------
    [Hulah] [Gorby] [CPC, CPMA]
    [Coding Supervisor]
    [Custom Data Services, Inc]
    [Merrillville] [IN]
    [219-769-1670]
    ------------------------------


  • 2.  RE: Comparative imaging study

    Posted 10-26-2020 09:14
    We worked quite a bit on this subject a few months ago. The key piece of information is that NCCI edits only apply when the procedures are performed by the same doctor/practice. Thus we do the following:

    Post-reductions - Since we don't perform reductions, we bill for the post-reduction study,

    Post-procedure (ie, thoracentesis, line placement, etc) - As long as we didn't perform the thoracentesis, line placement, etc, we bill for the post-procedure study.

    Subsequent imaging - In the event that an initial "post" study is not billed (for example, we perform the thoracentesis then do a non-billable cxr), we will bill for subsequent imaging as it is being performed for reasons other than verifying success of the procedure. (The report needs to support this, obviously.)





    Original Message


  • 3.  RE: Comparative imaging study

    Posted 10-26-2020 09:19
    Thank you Rick! ​

    ------------------------------
    [Hulah] [Gorby] [CPC, CPMA]
    [Coding Supervisor]
    [Custom Data Services, Inc]
    [Merrillville] [IN]
    [219-769-1670]
    ------------------------------

    Original Message


  • 4.  RE: Comparative imaging study

    Posted 10-26-2020 10:03

    The only thing I would add Hulah is I don't know why you would be applying a 52 modifier to that follow-up CXR.  What is being reduced?  This would be more of a bundling issue related to CCI.  It seems an XE would be more appropriate.

     

    And thanks for  your response Rick.  That has been my longstanding opinion.

     

    Ruby O'Brochta-Woodward BSN, CPC, CPMA, CPB, CPC-I, COSC, CSFAC, RCC

    Certified Medical Coder and Educator| Consulting Radiologists, Ltd.

    7505 Metro Blvd. | Suite 400 | Edina, MN | 55439

    Phone:  612.573.2223 | Fax:  612.573.2250

    ruby.obrochtawoodward@crlmed.com

    www.consultingradiologists.com


    Notice:  [CONFIDENTIALITY AND PRIVACY NOTICE] Information transmitted by this email is proprietary to Consulting Radiologists, Ltd.  and is intended for use only by the individual or entity to which it is addressed, and may contain information that is private, privileged, confidential or exempt from disclosure under applicable law. If you are not the intended recipient or it appears that this mail has been forwarded to you without proper authority, you are notified that any use or dissemination of this information in any manner is strictly prohibited. In such cases, please delete this mail from your records.

     

     

     




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  • 5.  RE: Comparative imaging study

    Posted 10-26-2020 11:14
    ​Hi Ruby, 
    The follow up x-rays state they are 'checking cath placement' even though it's later in the day and not immediate post cath/or tube placements.   I thought that -52 was appropriate?  No?
    I appreciate your comments. Thank you

    ------------------------------
    [Hulah] [Gorby] [CPC, CPMA]
    [Coding Supervisor]
    [Custom Data Services, Inc]
    [Merrillville] [IN]
    [219-769-1670]
    ------------------------------

    Original Message


  • 6.  RE: Comparative imaging study

    Posted 10-26-2020 16:53

    Someone else can step in but a 52 means that you provided less of a service than the code indicates, so fewer views than the minimum which wouldn't make sense since we have a 1 view chest.  I would be asking why if there was imaging done after the cath placement that another image is being done later in the day for the same reason.  Is your indication accurate? If it is and you were the physicians who placed the catheter then what is the medical necessity of taking another film to confirm something that was already confirmed? 

     

    Ruby O'Brochta-Woodward BSN, CPC, CPMA, CPB, CPC-I, COSC, CSFAC, RCC

    Certified Medical Coder and Educator| Consulting Radiologists, Ltd.

    7505 Metro Blvd. | Suite 400 | Edina, MN | 55439

    Phone:  612.573.2223 | Fax:  612.573.2250

    ruby.obrochtawoodward@crlmed.com

    www.consultingradiologists.com


    Notice:  [CONFIDENTIALITY AND PRIVACY NOTICE] Information transmitted by this email is proprietary to Consulting Radiologists, Ltd.  and is intended for use only by the individual or entity to which it is addressed, and may contain information that is private, privileged, confidential or exempt from disclosure under applicable law. If you are not the intended recipient or it appears that this mail has been forwarded to you without proper authority, you are notified that any use or dissemination of this information in any manner is strictly prohibited. In such cases, please delete this mail from your records.

     

     

     




    Original Message


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