New Year is coming! Get ready for new CPT coding changes. Radiology billing is one among the specialties to be aware of annual changes in coding system that needs to be entered into the minds of healthcare professionals simultaneously. Did you know that for radiology diagnosis, changes for the this year has focused on areas of abdominal, gastrointestinal plain films, along with nuclear medicine procedures for tumor localization as well as myocardial PET imaging.

Did you ever forget to update imaging? Oh no! Then that seems to be a bigger mistake! Radiology billing always demands updates of imaging uploads which aids in proper billing payments and prevention of revenue loss.

CPT coding changes for Radiology Billing:

  1. Diagnostic Radiology:
  • Abdominal and Gastrointestinal imaging exams include all scout films and delayed images of basic procedure codes with distinction made between single as well as contrast studies.
  • Complete Acute Abdomen Series:

74022 – A code that specifies two or more abdomen views including the example supine, erect and decubitus.

  • Pharynx and/or Cervical Esophagus:

 74210 – A code that specifies a barium contrast exam which includes scout neck radiographs and delayed images.

  • Esophagus:

The below codes include the scout chest radiographs as well as delayed images.

  1. 74220 code is used for single contrast exam
  2. 74221 code is used for double contrast exam with high density barium and an effervescent agent.
  • Swallowing Function:

74230 – This code specifies barium contrast exam including scout neck radiographs and delayed images.

  • Upper Gastrointestinal Tract:

These below codes include scout abdominal radiographs and delayed images as well.

  1. 74240 – This code is used for single contrast exam.
  2. 74246 – This code is used for double contrast exam including high density barium and also an effervescent agent with glucagon when administered.
  3. 74248 – Add this new code to either of these below codes in order to report small intestine follow up studies.
  • The replaced codes are:
  1. 74241 , the code is replaced by 74240
  2. 74245 , the code is replaced by 74240 + 74248
  3. 74247 , the code is replaced by 74246
  4. 74249 , the code is replaced by 74246 + 74248
  • Small Intestine:

The below codes include numerous serial images as well as scout abdominal radiographs and delayed images. Existing codes also are revised.

  1. 74250 – This code is used for single contrast exam.
  2. 74251 – This code is used for double contrast exam along with high density barium and air via enteroclysis tube.
  3. 74260 – This code is deleted and replaced by 74251 for Duodenogram.
  • Colon:

The below codes include scout abdominal radiographs as well as delayed images. The existing codes also have been revised.

  1. 74270 – This code is for single contrast exam
  2. 74280 – This code is for double contrast exam with high density barium and air that includes glucagon when administered.

Nuclear Medicine:

  • The below new codes are added to report tumour localization that includes SPECT and SPECT/CT.
  1. 78830 – SPECT with concurrent CT for anatomical review, localization and determination or detection of pathology. It works on single area including head, neck, pelvis and chest with single day imaging.
  2. 78831 – SPECT only for anatomical review, localization and determination or detection of pathology. It includes minimum two areas of abdomen and pelvis, knees and pelvis, with single day imaging or single area imaging for over two or more days.
  3. 78832 – SPECT with concurrent CT for anatomical review, localization and determination or detection of pathology. It covers minimum two areas including pelvis and knees, abdomen and pelvis with single day or area imaging for two or more days.
  4. 78835 – Radiopharmaceutical quantification measurements. It includes single area with the codes 78830 or 78832. Report multiple units for more than one area.
  • The above scans were earlier reported with codes 78805, 78806 and 78807.
  • The following codes are deleted and will be reported using tumour localization code 78803 including SPECT single area or single day of imaging.
  1. 78205 and 78206 Liver Imaging (SPECT)
  2. 78320 Bone and Joint Imaging (SPECT)
  3. 78607 Brain Imaging (SPECT)
  4. 78647 Cerebrospinal Fluid Flow Imaging (cisternography) (SPECT)
  5. 78710 Kidney Imaging (SPECT)

New enhanced codes for myocardial PET imaging in radiology billing:

  • 78459 – This code is revised for metabolic evaluation study including ventricular wall motion and/or ejection fractions, when performed along with single study.
  • 78429 – This code is new with concurrent CT imaging.
  • 78491 – This code is revised for Perfusion study including ventricular wall motion and/or ejection fractions, when performed with single study or at rest.
  • 78430 – This code is new for single study at rest or stress, with concurrent CT imaging.
  • 78492 – This code is revised for multiple studies at rest and stress.
  • 78431- This code is new for multiple studies at rest and stress along with concurrent CT imaging.
  • 78432 – This code is new for combined perfusion with metabolic evaluation study including ventricular wall motion and/or ejection fractions, when performed.
  • 78433 – This new code is for concurrent CT imaging.
  • 78434 – This code is add-on for Absolute quantitation of myocardial blood flow and rest and pharmacological stress with codes to include 78431 or 78492.

Hope you have got the information on Radiology Billing and new revision of codes. You can also go through the updated Radiology Coding Guide here. For more suggestions, please comment under the blog post. If you have any queries and more information on healthcare, please subscribe to our blog.