Here at Healthcare Information Services, we want to make sure that your radiology billing is ready for 2013. Because of the Health Insurance Portability and Accountability Act, the valid medical code set has to be used based on when the service was provided. This means that you needed to update your billing systems by January 1st, in order to keep billing nightmares from happening.
Most of the changes coming about in 2013 are based on the Relativity Assessment Workgroup's request to advance code changes in order to address code pairs that are, more than 75% of the time, reported together, as well as Harvard-valued codes that have a utilization higher than 30,000. Here are the major changes in radiology billing for 2013:
Cervical Spine Codes (Revised)
There was some confusion as to what constituted a complete study versus a minimum of four views (72052 and 72050), so the codes have been updated to clearly define this based on the work done.
- 72040 Radiologic examination, spine, cervical; three views or less
- 72050 four or five views
- 72052 six or more views
Bronchography has been replaced by computed tomography, so the codes used with bronchoscopy codes 31715 and 31656 no longer exist for 2013. In case of a bronchography, code 76499 should be used.
- 71040 Bronchography, unilateral, radiological supervision and interpretation (Deleted)
- 71060 Bronchography, bilateral, radiological supervision and interpretation (Deleted)
Thoracentesis and Pleural Drainage (New)
- 32554 Thoracentesis, needle or catheter, aspiration of the pleural space; without imaging guidance
- 32555 with imaging guidance
- 32556 Pleural drainage, percutaneous, with insertion of indwelling catheter; without imaging guidance
- 32557 with imaging guidance
- 32550 insertion of indwelling tunneled pleural catheter with cuff
- 32551 open procedure
Make sure not to report codes 32554-32557 with codes 32550, 32551, 76942, 77002, 77012, 77021, and 75989.
Pneumocentesis and Thoracentesis (Deleted)
These codes were identified as one of the Harvard-based codes with a utilization greater than 30,000. Four new codes will replace them (32554, 32555, 32556, and 32557), but sedation is not included, so it should be reported separately.
- 32420 Pneumocentesis, puncture of lung for aspiration (Deleted)
- 32421 Thoracentesis, puncture of pleural cavity for aspiration, initial or subsequent (Deleted)
In 2013, code 32551 (Tube thoracostomy, includes water seal, e.g. for abscess, hemothorax or empyema, when performed) will be used to describe an open procedure and will no longer be used for describing a percutaneous chest tube placement. Instead, code 32551 will describe a surgically placed chest tube involving incision and dissection extending through the parietal pleura, instead of a typical percutaneous tube placement done by a radiologist.
- 32422 Thoracentesis with insertion of tube, includes water seal (eg, for pneumothorax), when performed (separate procedure) (Deleted)
For more information on how the codes have changed for radiology billing, we suggest that you check out this article from the American College of Radiology. It includes all of the new, deleted, and revised codes for 2013, which should get you on your way to making sure that your radiology billing system is up-to-date.
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