Diagnostic Radiology New Codes & Changes-2011
Computed Tomography (CT), Abdomen and Pelvis
The ACR and other radiology specialty societies were asked to create a combined code set to describe CT abdomen and CT pelvis performed during the same session, as these codes are reported together greater than 75 percent of the time. Therefore, three new codes have been created to describe combined computed tomography (CT) of the abdomen and pelvis studies differentiated by without (74176), with (74177) and without followed by with (74178) contrast. The stand-alone CT abdomen (74150, 74160, 74170) and CT pelvis (72192, 72193, 72194) codes will remain, as there are times a CT abdomen or a CT pelvis will be performed as a stand-alone procedure
Deletion of Xeroradiography and Subtraction Codes
Codes for xeroradiography (76150) and subtraction in conjunction with contrast studies (76350) will be deleted in 2011, as these procedures are obsolete and have been replaced by newer technology.
The RUC Five-Year Identification Workgroup identified 76880 as having a significant increase in utilization attributable to an increase in a focused anatomic-specific ultrasound exam. The ACR in conjunction with the American Podiatric Medical Association worked to develop a code structure to differentiate the complete examination usually performed by radiologists from the limited exam usually performed by podiatrists. The work involved and the practice expense for a complete diagnostic ultrasound study is different than that of a focused study of a specific anatomic area. Therefore, code 76880, Ultrasound, extremity, nonvascular, real time with image documentation, will be deleted in 2011 and replaced by two new codes: 76881 (complete) and 76882 (limited, anatomic-specific). As described in the CPT 2011 code book, a complete procedure (76881) includes real time scans of a specific joint that includes examination of the muscles, tendons, joint, other soft-tissue structures, and any identifiable abnormality. A limited study (78882) is an examination of the extremity where a specific anatomic structure such as a tendon or muscle is assessed. In addition, the limited code would be used to evaluate a soft-tissue mass that may be present in an extremity where knowledge of its cystic or solid characteristics is needed. When spectral and color Doppler evaluation of the extremities is performed, use the appropriate code (93925-93926, 93930-93931, 93970 or 93971) in conjunction with 76881 or 76882. Noninvasive Vascular Diagnostic Ultrasound The noninvasive physiologic studies of the upper or lower extremity arteries, codes 93922-93924, have been revised and the codes revalued in response to a CPT/RUC Five-Year Review Identification workgroup request. The 2011 code descriptors clearly differentiate between a limited study and a complete bilateral study, Additional instruction also is provided on how to appropriately report these codes. See the CPT 2011 codebook introductory guidelines prior to thevasive Vascular Diagnostic Studies (93875-93990) section for detailed coding guidelines.