CPT 73510 - Upper and Lower Extremities Procedure codes - Radiology

UPPER EXTREMITIES

73000 Radiologic examination; clavicle, complete

73010 scapula, complete

73020 Radiologic examination, shoulder; one view

73030 complete, minimum of two views

73040 Radiologic examination, shoulder, arthrography, radiological supervision and interpretation
(Do not report 77002 in conjunction with 73040)

73050 Radiologic examination; acromioclavicular joints, bilateral, with or without weighted distraction

73060 humerus, minimum of two views

73070 Radiologic examination, elbow; two views

73080 complete, minimum of three views

73085 Radiologic examination, elbow, arthrography, radiological supervision and interpretation

(Do not report 77002 in conjunction with 73085)

73090 Radiologic examination; forearm, two views

73092 upper extremity, infant, minimum of two views

73100 Radiologic examination, wrist; two views

73110 complete, minimum of three views

73115 Radiologic examination, wrist, arthrography, radiological supervision and interpretation
(Do not report 77002 in conjunction with 73115)

73120 Radiologic examination, hand; two views

73130 minimum of three views

73140 Radiologic examination, finger(s), minimum of two views

73200 Computed tomography, upper extremity; without contrast material

73201 with contrast material(s)

73202 without contrast material, followed by contrast material(s) and further sections

73206 Computed tomographic angiography, upper extremity, with contrast material(s), including noncontrast images, if performed, and image postprocessing

73218 Magnetic resonance (eg, proton) imaging, upper extremity, other than joint; without contrast material(s)

73219 with contrast material(s)

73220 without contrast material(s), followed by contrast material(s) and further sequences

73221 Magnetic resonance (eg, proton) imaging, any joint of upper extremity; without contrast material(s)

73222 with contrast material(s)

73223 without contrast material(s), followed by contrast material(s) and further sequences

73225 Magnetic resonance angiography, upper extremity, with or without contrast material(s)


LOWER EXTREMITIES

73500 Radiologic examination, hip; unilateral, one view

73510 complete, minimum of two views

73520 Radiologic examination, hips, bilateral, minimum of two views of each hip, including anteroposterior view of pelvis

73525 Radiologic examination, hip, arthrography, radiological supervision and interpretation
(Do not report 77002 in conjunction with 73525)

73530 Radiologic examination, hip, during operative procedure

73540 Radiologic examination, pelvis and hips, infant or child, minimum of two views

73550 Radiologic examination, femur, two views

73560 Radiologic examination, knee; one or two views

73562 three views

73564 complete, four or more views

73565 both knees, standing, anteroposterior

73580 Radiologic examination, knee, arthrography, radiological supervision and interpretation
(Do not report 77002 in conjunction with 73580)

73590 Radiologic examination; tibia and fibula, two views

73592 lower extremity, infant, minimum of two views

73600 Radiologic examination, ankle; two views

73610 complete, minimum of three views

73615 Radiologic examination, ankle, arthrography, radiological supervision and interpretation
(Do not report 77002 in conjunction with 73615)

73620 Radiologic examination, foot; two views

73630 complete, minimum of three views

73650 Radiologic examination; calcaneus, minimum of two views

73660 toe(s), minimum of two views

73700 Computed tomography, lower extremity; without contrast material

73701 with contrast material(s)

73702 without contrast material, followed by contrast material(s) and further sections

73706 Computed tomographic angiography, lower extremity, with contrast material(s), including noncontrast images, if performed, and image postprocessing

73718 Magnetic resonance (eg, proton) imaging, lower extremity other than joint; without contrast material(s)

73719 with contrast material(s)

73720 without contrast material(s), followed by contrast material(s) and further sequence

73721 Magnetic resonance (eg, proton) imaging, any joint of lower extremity; without contrast material

73722 with contrast material(s)

73723 without contrast material(s), followed by contrast material(s) and further sequences

73725 Magnetic resonance angiography, lower extremity, with or without contrast material(s)

GASTROINTESTINAL , URINARY TRACT Procedure codes

GASTROINTESTINAL TRACT

74210 Radiologic examination; pharynx and/or cervical esophagus

74220 esophagus

74230 Swallowing function, with cineradiography/videoradiography

74235 Removal of foreign body(s), esophageal, with use of balloon catheter, radiological supervision and interpretation

74240 Radiologic examination, gastrointestinal tract, upper; with or without delayed films, without KUB

74241 with or without delayed films, with KUB,

74245 with small intestine, includes multiple serial films

74246 Radiological examination, gastrointestinal tract, upper, air contrast, with specific high density barium, effervescent agent, with or without glucagon; with or without delayed films, without KUB

74247 with or without delayed films, with KUB

74249 with small intestine follow-through

74250 Radiologic examination, small intestine, includes multiple serial films;

74251 via enteroclysis tube

74260 Duodenography, hypotonic

74270 Radiologic examination, colon; contrast (eg, barium) enema, with or without KUB

74280 air contrast with specific high density barium, with or without glucagon

74283 Therapeutic enema, contrast or air, for reduction of intussusception or other intraluminal obstruction (eg, meconium ileus)

74290 Cholecystography, oral contrast;

74300 Cholangiography and/or pancreatography; intraoperative, radiological supervision and interpretation

74301 additional set intraoperative, radiological supervision and interpretation
(List separately in addition to primary procedure)

(Use 74301 in conjunction with 74300)

74305 through existing catheter, radiological supervision and interpretation

74320 Cholangiography, percutaneous, transhepatic, radiological supervision and interpretation

74327 Postoperative biliary duct calculus removal, percutaneous via T-tube tract, basket or snare (eg, Burhenne technique), radiological supervision and interpretation

74328 Endoscopic catheterization of the biliary ductal system, radiological supervision and interpretation

74329 Endoscopic catheterization of the pancreatic ductal system, radiological supervision and interpretation

74330 Combined endoscopic catheterization of the biliary and pancreatic ductal systems, radiological supervision and interpretation

74340 Introduction of long gastrointestinal tube (eg, Miller-Abbott), including multiple fluoroscopies and films, radiological supervision and interpretation

74355 Percutaneous placement of enteroclysis tube, radiological supervision and interpretation

74360 Intraluminal dilation of strictures and/or obstructions (eg, esophagus), radiological supervision and interpretation

74363 Percutaneous transhepatic dilation of biliary duct stricture with or without placement of stent, radiological supervision and interpretation



URINARY TRACT

74400 Urography (pyelography), intravenous, with or without KUB, with or without tomography;

74410 Urography, infusion, drip technique and/or bolus technique;

74415 with nephrotomography

74420 Urography, retrograde, with or without KUB

74425 Urography, antegrade, (pyelostogram, nephrostogram, loopogram), radiological supervision and interpretation

74430 Cystography, minimum of three views, radiological supervision and interpretation

74440 Vasography, vesiculography, or epididymography, radiological supervision and interpretation

74445 Corpora cavernosography, radiological supervision and interpretation

74450 Urethrocystography, retrograde, radiological supervision and interpretation

74455 Urethrocystography, voiding, radiological supervision and interpretation

74470 Radiologic examination, renal cyst study, translumbar, contrast visualization, radiological supervision and interpretation

74475 Introduction of intracatheter or catheter into renal pelvis for drainage and/or injection, percutaneous, radiological supervision and interpretation

74480 Introduction of ureteral catheter or stent into ureter through renal pelvis for drainage and/or injection, percutaneous, radiological
supervision and interpretation

74485 Dilation of nephrostomy, ureters or urethra, radiological supervision and interpretation



GYNECOLOGICAL AND OBSTETRICAL

74710 Pelvimetry, with or without placental localization

74740 Hysterosalpingography, radiological supervision and interpretation

74742 Transcervical catheterization of fallopian tube, radiological supervision and interpretation

74775 Perineogram (eg, vaginogram, for sex determination or extent of anomalies)

RESPIRATORY NERVOUS Procedure codes

RESPIRATORY SYSTEM

78579 Pulmonary ventilation imaging (eg, aerosol or gas)

78580 Pulmonary perfusion imaging (eg, particulate)

78582 Pulmonary ventilation (eg, aerosol or gas) and perfusion imaging

78597 Quantitative differential pulmonary perfusion, including imaging when performed


78598 Quantitative differential pulmonary perfusion and ventilation (eg, aerosol or gas), including imaging when performed

78599 Unlisted respiratory procedure; diagnostic nuclear medicine


NERVOUS SYSTEM

78600 Brain imaging, less than 4 static views;

78601 with vascular flow

78605 Brain imaging, minimum 4 static views;

78606 with vascular flow

78607 Brain imaging, tomographic (SPECT)

78610 Brain imaging, vascular flow only

78630 Cerebrospinal fluid flow, imaging (not including introduction of material); cisternography

78635 ventriculography

78645 shunt evaluation

78647 tomographic (SPECT)

78650 Cerebrospinal fluid leakage detection and localization

78660 Radiopharmaceutical dacryocystography

78699 Unlisted nervous system procedure, diagnostic nuclear medicine



OTHER PROCEDURES

78800 Radiopharmaceutical localization of tumor or distribution of radiopharmaceutical agent(s); limited area


78801 multiple areas

78802 whole body, single day imaging

78803 tomographic (SPECT)

78804 Radiopharmaceutical localization of tumor or distribution of radiopharmaceutical agent(s); whole body, requiring two or more days
imaging

78805 Radiopharmaceutical localization of inflammatory process; limited area

78806 whole body

78807 tomograhic (SPECT)

78999 Unlisted miscellaneous procedure, diagnostic nuclear medicine

Procedure code 93600- Bundle of recording

Bundle of His Recording

93600 Bundle of His Recording

The physician places a venous sheath, usually in a femoral vein, using standard techniques. The physician advances an electrical catheter through the venous sheath and into the right heart under fluoroscopic guidance. The physician attaches the catheter to an electrical recording device to allow depiction of the intracardiac electrograms obtained from electrodes on the catheter tip. The physician moves
the catheter tip to the bundle of His, on the anteroseptal tricuspid annulus, and obtains recordings. Alternatively, the physician may obtain similar recordings by placing a catheter into the left ventricular outflow tract via the aorta

Coding Tips

1. Procedure code 93600 reports bundle of His recording only. For comprehensive electrophysiologic evaluation bundle of His recording, see 93619–93622.

2. Fluoroscopy is included in 93600 and is not reported separately.

3. Device edits apply to the code in this section.

4. Physician Reporting: This code has both a technical and  professional component. To report only the professional component, append modifier 26. To report only the technical component, append modifier TC. To report the complete procedure (i.e., both the professional and technical components), submit without a modifier.


Facility HCPCS Coding

HCPCS Level II codes are used to report the supplies provided during the procedure. Hospitals should separately report supplies used during cardiac invasive procedures. Refer to chapter 1 for more information regarding appropriate billing of supplies.

C1730 Catheter, electrophysiology, diagnostic, other than 3D mapping (19 or fewer electrodes)

C1731 Catheter, electrophysiology, diagnostic, other than 3D mapping (20 or more electrodes)

C1732 Catheter, electrophysiology, diagnostic/ablation, 3D or vector mapping

C1733 Catheter, electrophysiology, diagnostic/ablation, other than 3D or vector mapping, other than cool-tip

C2630 Catheter, electrophysiology, diagnostic/ablation, other than 3D or vector mapping, cool tip

C1766 Introducer sheath, guiding, intracardiac electrophysiological, steerable, other than peel-away

C1892 Introducer/sheath, guiding, intracardiac electrophysiological, fixed-curve, peel-away

C1893 Introducer/sheath, guiding, intracardiac electrophysiological, fixed-curve, other than peel-away


ICD-9-CM Codes

426.0 Atrioventricular block, complete

426.10 Unspecified atrioventricular block

426.11 First degree atrioventricular block

426.12 Mobitz (type) II atrioventricular block

426.13 Other second degree atrioventricular block

426.2 Left bundle branch hemiblock

426.3 Other left bundle branch block

426.4 Right bundle branch block

426.50 Unspecified bundle branch block

426.51 Right bundle branch block and left posterior fascicular block

426.52 Right bundle branch block and left anterior fascicular block

426.53 Other bilateral bundle branch block

426.54 Trifascicular block

426.6 Other heart block

426.7 Anomalous atrioventricular excitation

426.81 Lown-Ganong-Levine syndrome

426.89 Other specified conduction disorder

426.9 Unspecified conduction disorder

427.0 Paroxysmal supraventricular tachycardia

427.1 Paroxysmal ventricular tachycardia

427.2 Unspecified paroxysmal tachycardia

427.31 Atrial fibrillation

427.32 Atrial flutter

427.41 Ventricular fibrillation

427.42 Ventricular flutter

427.5 Cardiac arrest

427.60 Unspecified premature beats

427.61 Supraventricular premature beats

427.69 Other premature beats

427.81 Sinoatrial node dysfunction

427.89 Other specified cardiac dysrhythmias

427.9 Unspecified cardiac dysrhythmia

779.85 Cardiac arrest of newborn

780.2 Syncope and collapse

780.4 Dizziness and giddiness


CCI Edits

93600 00410, 00537, 0178T-0179T, 0180T, 0213T, 0216T, 0228T,  0230T, 12001-12007, 12011-12057, 13100-13153, 36000,  36005-36013, 36120-36140, 36400-36410, 36420-36430,  36440, 36555-36556, 36568-36569, 36600, 36640, 37202,  43752, 51701-51703, 62310-62319, 64400-64435,  64445-64450, 64479, 64483, 64490, 64493, 64505-64530, 75896, 76000-76001, 76942, 76998, 77001-77002, 92960-92961, 93000-93010, 93040-93042, 93318, 93451-93461, 93530-93533, 93563, 93565-93568, 94002, 94200, 94250, 94680-94690, 94770, 95812-95816, 95819, 95822, 95829, 95955, 96360, 96365, 96372, 96374-96376, 99148-99150


Device Edits

93600 C1730, C1731, C1732, C1733, C1766, C1892, C1893, C1894, C2629, C2630

Procedure code 37204 and 75894

Percutaneous Embolization—Peripheral and Visceral Vessels

Transcatheter embolization is performed with the intent to occlude the blood vessels supplying a previously determined abnormality such as a tumor or aneurysm. Once the blood supply to the abnormality is determined, selective or super-selective catheterization of the feeder vessels is performed and embolic material is injected or placed in each vessel. The most common embolic materials available are gelfoam, coils, glue, balloons, microspheres, and polyvinyl alcohol. Chemo drugs are also used for certain embolization situations. Follow-up angiography is performed to determine the success of the therapy and is coded separately.

37204 Transcatheter occlusion or embolization (eg, for tumor destruction, to achieve hemostasis, to occlude a vascular malformation), percutaneous, any method, non-central nervous system, non-head or neck  A needle is inserted through the skin and into a blood vessel, and a guidewire is threaded through the needle into the vessel. The needle is removed. A catheter is then threaded into the vessel, and the wire extracted.  The catheter travels to the point of the malformation and beads or another vessel-blocking device are released. The beads or other device block the vessel. The catheter is then removed and pressure is applied over the puncture site to stop bleeding.

75894 Transcatheter therapy, embolization, any method,  radiological supervision and interpretation A blood vessel is blocked by inserting an occlusive agent under fluoroscopic monitoring to stop or restrict the blood flow. This is done to restrict blood supply to a tumor, treat vascular malformations, or control hemorrhaging. A local anesthetic is given at the puncture site and a needle is inserted into the selected vessel followed by a guidewire. The needle is removed. A catheter is then inserted over the guidewire and advanced to the vessel requiring treatment. A blocking agent is carefully injected or inserted and monitored for the occlusion or restriction desired. The effect may remain permanent or require another transcatheter embolization with time. This code reports the radiological supervision and interpretation only. Use a separately reportable code for the catheterization.

Radiology Procedure code list

Diagnostic Radiology (Diagnostic Imaging) Procedure code 70010-76499

Aorta and Arteries Procedure code 75600-75790

Diagnostic Ultrasound Procedure code 76506-76999

Radiation Oncology Procedure code 77261-77799

Clinical Treatment Planning Procedure code 77261-77299

Radiation Treatment Management Procedure code 77427-77499

Proton Beam Treatment Delivery Procedure code 77520-77523

Hyperthermia Procedure code 77600-77620

Clinical Brachytherapy Procedure code 77750-77799

Nuclear Medicine Procedure code 78000-78299

Musculoskeletal System Procedure code 78300-78399

Cardiovascular System Procedure code 78414-78499

CT and CTA's	CPT Code
CT abdomen and pelvis w/o contrast; renal stone	74176
CT abdomen and pelvis; with contrast i.e. enterography	74177
CT abdomen and pelvis; w/o contrast followed by with contrast	74178
CT abdomen w/o followed by contrast	74170
CT abdomen; w/o contrast	74150
CT abdomen; with contrast	74160
CT ablation renal radiofrequency	50592
CT cervical spine; w/o contrast	72125
CT cervical spine; w/o contrast followed by with contrast	72127
CT cervical spine; with contrast	72126
CT chest (thorax) w/o contrast followed by contrast	71270
CT chest (thorax) w/o contrast - high resolution - limited	71250
CT chest (thorax) with contrast, chest tube placement	71260
CT CTA Abdomen/Pelvis Panel	74174
CT CTA Abdomen/Pelvis Panel; two separate   orders/codes	71275, 74174
CT CTA Chest/Abdomen Panel; two separate orders/codes	71275, 74175
CT head or brain; w/o contrast, stroke protocol	70450
CT head or brain; w/o contrast followed by with contrast	70470
CT head or brain; with contrast	70460
CT heart score	76380
CT heart; w/o contrast, calcium scoring	75571
CT lower extremity; w/o contrast	73700
CT lower extremity; w/o contrast followed by contrast	73702
CT lower extremity; with contrast	73701
CPT Code Tool
CT lumbar spine; w/o contrast	72131
CT lumbar spine; w/o contrast followed by with contrast	72133
CT lumbar spine; with contrast	72132
CT maxillofacial area limited w/o contrast, sinus	70486
CT maxillofacial area; w/o contrast followed by with contrast	70488
CT maxillofacial area; with contrast	70487
CT maxillofacial area; w/o contrast	70486
CT neck soft tissue w/o contrast	70490
CT neck soft tissue with contrast	70491
CT orbit; sella or posterior fossa; w/o contrast	70480
CT orbit; sella or posterior fossa; w/o contrast followed by with contrast	70482
CT orbit; sella or posterior fossa; with contrast	70481
CT pelvis; w/o contrast	72192
CT pelvis; w/o contrast followed by with contrast	72194
CT pelvis; with contrast	72193
CT soft tissue neck; w/o contrast	70490
CT soft tissue neck; w/o contrast followed by with contrast	70492
CT soft tissue neck; with contrast	70491
CT thoracic spine; w/o contrast	72128
CT thoracic spine; w/o contrast followed by with contrast	72130
CT thoracic spine; with contrast	72129
CT upper extremity; w/o contrast	73200
CT upper extremity; w/o contrast followed by contrast	73202
CT urogram	74178
CT upper extremity; with contrast	73201
CTA abdomen; w/o contrast followed by contrast and further sections	74175
CTA chest no coronary	71275
CPT Code Tool
CTA head and neck (order separately)	70496, 70498
CTA head; w/o contrast followed by with contrast	70496
CTA heart coronary arteries and cardiac structure	75574
CTA lower extremity	73706
CTA neck; w/o contrast followed by with contrast	70498
CTA pelvis; w/o contrast followed by with contrast	72191
CTA runoff AAA bilateral lower extremity	75635
CTA upper extremity	73206

Interventional Radiology/Cardiology CPT Code 

Abscess Drain; peritoneal 49021
Abscess Drain; retroperitoneal 49061
Angiogram, renal, unilateral 36251
Angiogram, renal, bilateral 36252
Biopsy abdominal mass, percutaneous needle 49180
Biopsy liver, percutaneous needle 47000
Biopsy lung, percutaneous needle 32405
Biopsy renal, percutaneous needle or trocar 50200
Biopsy thyroid, percutaneous core needle 60100
Cardiac cath bilateral 93453
Cardiac cath left heart 93452
Cardiac cath right heart 93451
Cardioversion elective 9296
Carotid Cerebral 36223
Echo adult or pediatric complete 93306
Echo adult or pediatric limited 93308
Echo fetal, order three codes 76827, 76825 93325
Echo stress 93351
Echo transesophageal,  TEE 93318
Echo transthoracic ; congenital anomalies 93303
Echo transthoracic ; congenital anomalies follow-up 93304
Echo with doppler ;with bubbles or contrast 93306
EKG 12 lead 93005
EKG signal averaged 93278
Electrophysiology (EP) study with arrhythmia 93619
EP Study without arrhythmia 93620
EP ablation AV node 93650
EP ablation for SVT 93653
EP ablation for V-Tach 93654
EP Followup study, NIPS 93624
Event monitor external 93268
Event monitor implant 33282
Fluoro, lead check or valve 76000
Holter monitor up to 48 hours 93225
ICD insert or replacement with leads 33249
ICD insert replacement pulse generator only 33240
ICD non-invasive test (NIPS) 93642
Nephrostogram with needle; percutaneous 50390
Nephrostogram through tube or indwelling ureteral catheter 50394
Pacemaker insert new dual chamber with leads 33208
Pacemaker insert new single chamber with ventricular leads 33207
Pacemaker replace dual chamber pulse generator only 33213
Pacemaker replace single chamber pulse generator only 33212
Patent foramen ovale (PFO) closure 93580
Pericardiocentesis 33010Procainamide infusion 93623
Tilt table evaluation 93660
Shuntogram, graft or fistula 36147
Stress test 93017
Thrombolysis AV fistula 36870
Valvuloplasty, aortic 92986
Valvuloplasty,mitral 92987
Valvuloplasty, pulmonary 92990

List of MRA Procedure code which required Authorization

MRA
70544 Head w/o contrast
70545 Head w/contrast
70546 Head w/ & w/o contrast
70547 Neck w/o contrast
70548 Neck w/contrast
70549 Neck w/o & w/contrast
71555 Chest w/ or w/o contrast
72198 Pelvis w/ or w/o contrast
73225 UE w/ or w/o contrast
73725 LE w/ or w/o contrast
74185 Abdomen w/ or w/o contrast
MRI
70336 TMJ
70540 Face, orbit, &/or neck w/o contrast
70542 Face orbit &/or neck w & w/o cont.
70543 Face,orbit, &/or neck w & w/o cont.
70551 Brain w/o contrast
70552 Brain w/ contrast
70553 Brain w/& w/o contrast
71550 Chest w/o contrast
71551 Chest w/ contrast
71552 Chest w & w/o contrast
72141 C-spine w/o contrast
72142 C-spine w/contrast
72146 T-spine w/o contrast
72147 T-spine w/contrast
72148 L-spine w/o contrast
72149 L spine w/contrast
72156 c-spine w/ & w/o contrast
72157 T-spine w/ & w/o contrast
72158 L-spine w/ & w/o contrast
72195 Pelvis w/o contrast
72196 Pelvis w/ contrast
72197 Pelvis w/&w/o contrast
73218 UE w/o contrast
73219 UE w/contrast
73220 UE w/& w/o contrast
73221 UE joint w/o contrast
73222 UE joint w/contrast
73223 UE joint w/& w/o contrast
73718 LE w/o contrast
73719 LE w/ contrast
73720 LE w/ & w/o contrast
73721 LE joint w/o contrast
73722 LE joint w/ contrast
73723 LE joint w & w/o contrast
74181 Abdomen w/o contrast
74182 Abdomen w/contrast
74183 Abdomen w & w/o contrast
75557 Cardiac w/o contrast
75559 Cardiac w/o contrast,w/stress imag.
75561 Cardiac w & w/o contrast
75563 Cardiac w & w/o contrast,w stress imag.
76498 Unlisted magnetic resonance procedure
77058 Breast w/ & or w/o contrast, unilat.
77059 Breast w/& or w/o contrast, bilat.
77084 Bone marrow blood supply

RADILOGY Procedure code list authorization required

Procedure  code 

70450 Head/brain w/o contrast
70460 Head/brain w/ contrast
70470 Head/brain w/o & w/contrast
70480 Orbit w/o contrast
70481 Orbit w/ contrast
70482 Orbit w/o & w/contrast
70486 Maxllfcl w/o contrast
70487 Maxllfcl w/ contrast
70488 Maxllfcl w/o & w/contrast
70490 Soft tissue neck w/o contrast
70491 Soft tissue neck w/o, w/contrast
70492 Soft tissue neck w/o & w/contrast
71250 Thorax w/o contrast
71260 Thorax w/contrast
71270 Thorax w/o & w/contrast
72125 C-spine w/o contrast
72126 C-spine w/contrast
72127 C-spine w/o & w/contrast
72128 T-spine w/o contrast
72129 T- spine w/contrast
72130 T-spine w/ & w/o contrast
72131 L-spine w/o contrast
72132 L-spine w/contrast
72133 L-spine w/o & w/ contrast
72192 Pelvis w/o contrast
72193 Pelvis w/contrast
72194 Pelvis w/o & w/ contrast
73200 UE- w/o contrast
73201 UE- w/contrast
73202 UE w/o & with contrast
73700 LE w/o contrast
73701 LE w/ contrast
73702 LE w/o & w/contrast
74150 Abdomen w/o contrast
74160 Abdomen w/contrast
74170 Abdome w/o & w/contrast
76380 Limited or localized f/u study
76497 Unlisted Computed Tomography procedure

Billing PROCEDURE CODE Q0092, R0070, R0075

Set-Up Component (HCPCS Code Q0092)

Carriers must pay a set-up component for each radiologic procedure (other than retakes of the same procedure) during both single patient and multiple patient trips under Level II HCPCS code Q0092. Carriers do not make the set-up payment for EKG services furnished by the portable x-ray supplier.

Transportation of Equipment Billed by a SNF to an FI

When a SNF bills for portable x-ray equipment transported to a site by van or other vehicle, the SNF should bill for the transportation costs using one of the following HCPCS codes along with the appropriate revenue code:

R0070 Transportation of Portable x-ray Equipment and Personnel to Home or Nursing Home, Per Trip to Facility or Location, One Patient Seen.

R0075  Transportation of Portable x-ray Equipment and Personnel to Home or Nursing Home, Per Trip to Facility or Location, More than One Patient Seen, Per Patient.

These HCPCS codes are subject to the fee schedule.

Effective April 1, 2006, SNFs are required to report the appropriate modifiers to identify the number of patients served when billing for R0075. See section 90.3, of this chapter for the list of modifiers used to identify on the claim the number of patients served.

Fiscal intermediaries shall ensure that payment for R0075 is consistent with the definition of the modifiers.

Modifiers for Transportation of Portable X-rays (R0075) 

Policy: Medicare allows a single transportation payment for each trip the portable x-ray supplier makes to a particular location. Some contractors currently use the units field of the Medicare claim form to prorate the services to determine the appropriate single payment. This results in inconsistencies in reporting of these services among providers and contractors, and inflates the national frequency data based on the units field for these services. Therefore, effective upon implementation of this document, the five (5) new modifiers previously implemented for R0075 in CR 2856, Transmittal 14, shall be used to report the number of patients served during a single trip. These modifiers are listed below. NOTE: If only one patient is served, R0070 should be reported with no modifier since the descriptor for this code reflects only one patient seen.

UN Two patients served
UP Three patients served
UQ Four patients served
UR Five patients served
US Six patients or more served

Payment for the above modifiers must be consistent with the definition of the modifiers. Therefore, for R0075 reported with modifiers, -UN, -UP, -UQ, and –UR, the total payment for the service shall be divided by 2, 3, 4, and 5 respectively. For modifier –US, the total payment for the service shall be divided by 6 regardless of the number of patients served. For example, if 8 patients were served, R0075 would be reported with modifier –US and the total payment for this service would be divided by 6.

The units field for R0075 shall always be reported as “1” except in extremely unusual cases. The number in the units field should be completed in accordance with the provisions of 100-04, chapter 23, section 10.2 item 24 G which defines the units field as the number of times the patient has received the itemized service during the dates listed in the from/to field. The units field must never be used to report the number of patients served during a single trip. Specifically, the units field must reflect the number of services that the specific beneficiary received, not the number of services received by other beneficiaries.

R0075 must be billed in conjunction with the procedure  radiology codes (70000 series) and only when the x-ray equipment used was actually transported to the location where the x-ray was taken. R0075 would not apply to the x-ray equipment stored in the location where the x-ray was done (e.g., a nursing home) for use as needed.

Determining Payment for Multiple Patients Served

Medicare will make payment for the modifiers based on the definition of the modifier. The payment for serving a single patient (R0070) will be used as the base rate for R0075 (more than one patient seen), and will be prorated for the number of patients served. For example:

• If R0075 is reported with modifiers UN, UP, UQ, and UR, the total payment for a single patient served will be divided by the 2, 3, 4, and 5 respectively.

• If R0075 is reported with modifier US, the total payment for a single patient served will be divided by 6 regardless of the number of patients served. For example, if eight patients were served, R0075 would be reported with modifier US, and the total payment for a single patient for this service would be divided by 6.

The units field for R0075 will almost always be reported as “1.” The number in the units field indicates the number of times the patient received the itemized services on the “line item date of service” specified on the same line.

The units field must reflect the number of services received by a specific beneficiary only, not the number of services received by other beneficiaries. The unit field must never be used to report the number of patients served during a single trip.

HCPCS code R0075 must be billed with the Current Procedural Terminology  radiology codes (7000 series) and only when the x-ray equipment used was actually transported to the location where the x-ray was taken. R0075 should not be billed for the use of x-ray equipment that is stored in the location where the xray is done (e.g., a nursing home) for use as needed.

Please be aware that Medicare will return to the provider claims containing R0075 when billed without one of the five modifiers. 

PROCEDURE CODE 77401 - 77416 & 77750 - 77799 & 77300 - 77399 Radiation physical services

Radiation Treatment Delivery (Procedure code 77401 - 77417)

Carriers pay for these TC services on a daily basis under Procedure codes 77401-77416 for radiation treatment delivery. They do not use local codes and RVUs in paying for the TC of radiation oncology services. Multiple treatment sessions on the same day are payable as long as there has been a distinct break in therapy services, and the individual sessions are of the character usually furnished on different days. Carriers pay for Procedure code 77417 (Therapeutic radiology port film(s)) on a weekly (five fractions) basis.

Clinical Brachytherapy (Procedure Codes 77750 - 77799)

Carriers must apply the bundled services policy to procedures in this family of codes other than Procedure code 77776. For procedures furnished in settings in which TC payments are made, carriers must pay separately for the expendable source associated with these procedures under Procedure code 79900 except in the case of remote after-loading high intensity brachytherapy procedures (Procedure codes 77781-77784). In the four codes cited, the expendable source is included in the RVUs for the TC of the procedures.

Radiation Physics Services (Procedure  Codes 77300 - 77399)

Carriers pay for the PC and TC of Procedure codes 77300-77334 and 77399 on the same basis as they pay for radiologic services generally. For professional component billings in all settings, carriers presume that the radiologist participated in the provision of the service, e.g., reviewed/validated the physicist’s calculation. Procedure codes 77336 and 77370 are technical services only codes that are payable by carriers in settings in which only technical component is are payable.

Procedure g0210 and g0230

On July 1, 2001, HCPCS codes G0210 - G0230 were added to allow billing for all currently covered indications for FDG PET. Although the codes do not indicate the type of PET scanner, these codes were used until January 1, 2002, by providers to bill for services in a manner consistent with the coverage policy.

Effective January 1, 2002, HCPCS codes G0210 – G0230 were updated with new descriptors to properly reflect the type of PET scanner used. In addition, four new HCPCS codes became effective for dates of service on and after January 1, 2002, (G0231, G0232, G0233, G0234) for covered conditions that may be billed if a gamma camera is used for the PET scan. For services performed from January 1, 2002, through January 27, 2005, providers should bill using the revised HCPCS codes G0210 - G0234. Beginning January 28, 2005 providers should bill using the appropriate Procedure code.