1. The Complete Procedure Coding Book By Shelley C
The Complete Procedure Coding Book By Shelley C. Safian, MAOM/HSM, CCS-P, CPC-H, CHA
Chapter 9
Radiology
McGraw Hill/Irwin
Copyright © 2009 by The McGraw-Hill Companies, Inc. All rights reserved

2. Learning Outcomes
9-2
Apply the guidelines to determine the best, most appropriate codes.
List the various types of imaging techniques.
Decide when to code radiologic services as a companion to a surgical procedure.

3. Learning Outcomes
9-3
Distinguish between technical and supervision & interpretation components.
Correctly apply guidelines regarding the use of additional codes.
Determine how and when to use modifiers.

4. Introduction
9-4
No longer just the x-ray department, radiologic imaging is done in hospitals and free-standing facilities to diagnose, monitor, and treat patients.

5. Technical Component Equipment Technician Maintenance
9-5
Provides reimbursement for the cost of the:
Equipment
Technician
Maintenance
Utilities (electricity, etc.)
Supplies

6. Professional Component
9-6
To gain reimbursement for the:
Health care professional, radiologist or physician who supervises and interprets the images taken and writes a report for the patient’s record.
When a professional only provides the professional component, use modifier 26.

7. Radiologic Views AP Anteroposterior (front to back)
9-7
Most common angles of imaging:
AP Anteroposterior (front to back)
PA Posteroanterior (back to front)
Oblique At an angle
RAO Right anterior oblique
RPO Right posterior oblique
LAO Left anterior oblique
LPO Left posterior oblique
Lat Lateral

8. Contrast Arthrography Computerized tomography
9-8
Some procedures can be taken with or without contrast materials, or both
Arthrography
Computerized tomography
Magnetic resonance imaging
Magnetic resonance arthrography

9. Diagnostic Angiography
9-9
Some codes include a diagnostic angiography done at the same time.
Some exclusions exist to code this separately.
CPT outlines circumstances to make the determination.

10. Diagnostic Venography
9-10
Some codes include a diagnostic venography done at the same time.
Some exclusions exist to code this separately.
CPT outlines circumstances to make the determination.

11. Transcatheter Procedures
9-11
Therapeutic transcatheter radiologic codes include:
Vessel measurement
Post-angioplasty or stent venography
Contrast injections, angiography/ venography, road mapping, and/or fluoroscopic guidance

12. Diagnostic Ultrasound
9-12
1. Identify complete or limited
Identify type of scan
A mode
M mode
B scan
Real-time scan

13. Diagnostic Ultrasound
9-13
If the report indicates that a Doppler evaluation of vascular structures was performed,
code this separately.

14. Radiation Oncology Codes include: Initial consultation
9-14
Codes include:
Initial consultation
Clinical treatment planning
Simulation
Medical radiation physics
Dosimetry
And….

15. Radiation Oncology Treatment devices Special services
9-15
Treatment devices
Special services
Clinical treatment management procedures
Normal follow-up care during treatment + 3 months following completion of treatment

16. Radiation Oncology Simple planning. Intermediate planning.
9-16
Treatment planning may be:
Simple planning.
Intermediate planning.
Complex planning.

17. Nuclear Medicine
9-17
Treatment that includes the injection or digestion of isotopes
These codes do NOT include diagnostic or therapeutic radiopharmaceuticals (drugs).
Code administration and the drug itself separately.

18. Chapter Summary
9-18
Imaging methodology has advanced tremendously. Whether with contrast, without contrast, MRI, CT scans, PET, and sonograms, coders must be knowledgeable about these techniques.