Are you still unbundling your imaging codes? Turns out that in 2019, unbundling can be considered fraudulent – even if it’s done accidentally.
A firm understanding of what includes imaging and what does not is imperative for all organizations. Another new year brings a great opportunity to review CPT code descriptions, National Correct Coding Initiative (NCCI) edits and coding clinics that reference bundling.
This year, the CPT and NCCI manuals updated multiple categories in efforts to create new codes that would include imaging. Here are some examples:
- Fine needle aspiration – Codes 10004-10021
- Transcatheter pulmonary valve implantation – Code 33477
- Central venous catheters and peripherally inserted catheters – Codes 36568-36584
- Pacemakers – many codes state that radiologic supervision may not be reported separately
- Replacement of gastrostomy tube – new codes for without imaging – 43762 and 43763
The CPT and NCCI manuals also clarify that in 2019, you can separately report specific radiology or imaging procedures with certain categories. Here are some examples:
- Radiologic procedures with injection for contrast knee arthrography – Code 27369
- Fluoroscopy (76000) with codes 50080 and 50081
When imaging can be separately reported, per CPT and NCCI guidelines, it still requires the following documentation and parameters.
As with all coding, there are exceptions to these rules which can be found in the CPT and NCCI guidelines and at the code level in the CPT manual.
Are you ready for all these 2019 updates?,/p>
Do you have a plan on how to educate your staff?
Don’t delay – now is your chance to share these 2019 imaging updates with your staff.
At Ensemble Health Partners, our leadership team hosts an annual webinar to invest in the continuing education of revenue cycle associates in the industry. During this webinar, we focus on CPT/HCPCS updates, status indicator modification and imaging guidelines targeting areas in CDI, HIM and coding.
If you’d like to check out our HIM, CDI and coding webinar, please visit https://vimeo.com/307098632/11e2fee8b3 to see how Ensemble Health Partners prepares for these 2019 updates.
Author: Staci Booth
Staci Booth is the Coordinator of Education and Coding Quality at Ensemble Health Partners where she is responsible for the development of HIM, CDI and Coding associates. She has over 20 years of coding, billing and auditing experience, and has been an educator in the healthcare industry for the last 11 years. Staci has certifications as a CPC, CCS and CRCR and is an AHIMA approved ICD-10-CM/PCS Trainer.