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CODING CORNER: Master Your CDM Updates for 2006

Infusion and radiology changes top the list

If you haven鈥檛 introduced the 2006 updates into your CDM yet, you could be losing reimbursement left and right--not to mention inviting a whole new crop of compliance errors. Check your chargemaster to see if you鈥檝e implemented these crucial changes.
Code for the Latest Gadgets
Radiology departments need to adopt a host of changes this year, including three new code descriptors, 18 new codes and nine deletions, says Glenda Schuler, RHIT, CPC, CPC-H, senior chargemaster consultant for Ingenix in Las Vegas. Among the new codes are several category III codes to describe new technology. Category III codes will receive updates twice yearly for Medicare patients to ensure reimbursement for treatment from valuable new devices, says Schuler, who presented on chargemaster updates at the Ingenix Fifth Annual Coding, Billing, and Compliance Essentials Conference.
For example, you can now report computer-aided lesion detection with category III code +0152T (Computer-aided detection [computer algorithm analysis of digital image data for lesion detection] with further physician review for interpretation, with or without digitization of film radiographic images; chest radiograph[s] [list separately in addition to code for primary procedure]).
You have four new Category III codes for cardiac catheterization procedures:

鈥� 0145T--Computed tomography, heart, without contrast  material followed by contrast material(s) and further sections, including cardiac gating and 3D image post processing; cardiac structure and morphology

鈥� 0146T--鈥� computed tomographic angiography of coronary arteries (including native and anomalous coronary arteries, coronary bypass grafts), without quantitative evaluation of coronary calcium

鈥� 0147T--鈥�with quantitative evaluation of coronary calcium

鈥� 0148T--鈥� cardiac structure and morphology and computed tomographic angiography of coronary arteries (including native and anomalous coronary arteries, coronary bypass grafts), without quantitative evaluation of coronary calcium

鈥� 0149T--鈥�with quantitattive evaluation of coronary calcium.
Specify Dimensions for 76376 and 76377
Your radiology department will also need to ax 76375 (Coronal, sagittal, multiplanar, oblique, 3-dimensional and/or holographic reconstruction of computed tomography, magnetic resonance imaging, or other tomographic modality) in favor of two new, more dimensionally precise codes: 76376 and 76377. Unlike 76375, which described a rendering that could be 2D, 3D, or holographic, the new codes require a 3D image.
These are the two new codes that will replace 76375:

鈥� 76376--3D rendering with  interpretation and reporting of computed tomography, magnetic resonance imaging, ultrasound, or other tomographic modality; not requiring image postprocessing on physician documentation, and we need to educate our [cardiologists] to tell us explicitly鈥� what type of hypertension they鈥檙e treating, says Charla Prillaman, CPC, CHCO, director of physician compliance for Carolinas Healthcare System in Charlotte, N.C. Cardiologists need to state the details of a patient鈥檚 hypertension in the medical record, she adds.
Coding for hypertension 鈥渞eally comes down to documentation,鈥� agrees Jaime Darling, CPC, a coder with Graybill Medical Group in Escondido, [...]

- Published on 2006-01-20