Radiology procedures / coding

[fedor]

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Taking a look at the following:

http://www.ctmedicalprogram.com/prmanuals/fee_physician_20020501.pdf

I noticed that there are 28 pages of radiology procedures and codes. Does it eventually become second nature to radiologists and they'll immediately be able to tell you the CPT code for most of these procedures? Or is this another example of the increased complexity of health care necessitating administrators to deal with such issues.

In the far right, under the column TOS, I assume that's the amount of reimbursement for the physician reading the scan? And that there would be a seperate fee schedule for the equipment?

 

[Docxter]

Taking a look at the following:

http://www.ctmedicalprogram.com/prmanuals/fee_physician_20020501.pdf

I noticed that there are 28 pages of radiology procedures and codes. Does it eventually become second nature to radiologists and they'll immediately be able to tell you the CPT code for most of these procedures? Or is this another example of the increased complexity of health care necessitating administrators to deal with such issues.

In the far right, under the column TOS, I assume that's the amount of reimbursement for the physician reading the scan? And that there would be a seperate fee schedule for the equipment?

Wow, these are pretty good rates. Where we are, bluecross-blueshield pays much less than these, often less than a half of the rates above. The MRI rates at our place are about 1/3 of the above.

 

[fedor]

I'm surprised at just how many types of scans are listed in those 28 pages. Those 4 years of radiology residency must be pretty intense indeed.

For example, haven't myelographies been almost entirely replaced by MRI? Would radiologists still be trained in myelography because of the few patients who can't undergo MRI (ie, pacemaker)?

 

[Whisker Barrel Cortex]

I'm surprised at just how many types of scans are listed in those 28 pages. Those 4 years of radiology residency must be pretty intense indeed.

For example, haven't myelographies been almost entirely replaced by MRI? Would radiologists still be trained in myelography because of the few patients who can't undergo MRI (ie, pacemaker)?

We still do about 6-7 myelograms a week here. The fluoroscopic examination is followed by a CT scan. Mostly its either people that can't have an MRI or those with hardware in the back which makes MRI problematic.

We definitely learn a very large number of different types of studies during residency. Once you've learned the principles of the imaging, new studies are generally less difficult to understand.

 

[f_w]

Does it eventually become second nature to radiologists and they'll immediately be able to tell you the CPT code for most of these procedures?


Entirely depends on how the practice you work for does its billing:

- If the practice bills off your reports, all you need to have in there are the correct verbal descriptors. A computer program aided by a trained medical biller will translate that into the correct CPTs (and do the necessary edits).

- If you have to code you studies, of course you will have the numbers down cold after a while. Some of the older private practice guys who did this type of typically in-house billing can rattle all the 28 pages from their memory.

In IR you will still find physicians doing their own coding. It is incredibly byzantine and complex. If you did the procedure and you have an understanding of IR billing, it is a lot easier to generate the codes yourself rather than having a biller extract the information from your report.

 

[f_w]

The conventional myelogram is pretty much dead. But as WBC pointed out, CT-myelograms are not so uncommon, mainly in pacemaker patiens and post-surgical backs.