Understanding Radiology Coding — Radiology Coding Guidelines

Understanding Radiology Coding — Radiology Coding Guidelines http://go.cco.us/cpt-2015-updates

Laureen: Okay, radiology coding contrast question. Theresa states, “I’m so confused. Can you please go over the paragraph entitled, ‘Administration of Contrast Material’ in the Radiology Guidelines on page 361 of the CPT manual, in particular, the 2nd paragraph regarding arthrography? Also, does the 2nd paragraph correlate with Laureen’s chart for administration of a contrast or is it totally unrelated?”

So let’s go to our answer sheet here. This is a scan of my guideline page about administration of contrast. Now if you’ve listened to these before, you know you’ve heard me say I’m a very visual learner. When I see paragraphs like this, I’m like, “Oh dear God, help me make it visual.” So this was the initial attempt where we were underlying… so let’s just kind of read and then I’m going to show you my visual attempt and see what you like better.

So first thing you have to understand with contrast is oral and rectal. For radiology coding purposes, does that count. You can’t code any of the radiology codes that say with contrast if it was given orally or rectally. Okay so the phrase ‘with contrast’ using the codes for procedures performed using contrast for imaging enhancement represents contrast material administered. And these are the 3 separate ways — intravascularly… so they’re going into a vessel and that means vein or artery. And then intraarticularly. A lot of people mix it up and think that means the artery. It’s articularly which is talking about the joints. And then intrathecally which means into the spine… so a little note there that it means into spine.

So then this first paragraph talks about for intraarticular injection, use the appropriate joint injection code. So the guidelines are letting us know, in addition to the radiology code, we can also code a joint injection code. If radiographic arthrography is performed, also use the arthrography supervision and interpretation code. So in order to get that needle into that joint space, you’re probably going to need some imaging to help you do that which is ironic because you’re doing it in order to do xray or CT scan or whatever. Okay so that’s what this is saying. It’s basically a permission statement letting you know what you can code in addition to the regular radiology code.

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