Question 1

The patient with possible brain damage received a functional MRI of the brain with administration of repetitive body part movements and visual stimulation. Due to the type of brain injury, the physician was required to administer all of the neurofunctional tests. The physician reviewed the test results and reported his findings to the patient's primary care physician. What is the correct code for this visit?

Accepted Answer

The correct code for this visit is 96020 (Neurofunctional Testing Selection and Administration During Non-Invasive Imaging Functional Brain Mapping, with Test Administered Entirely by a Physician, with Review or Test Results and Report) and 70555 (Magnetic Resonance Imaging, Brain, Functional MRI; Requiring Physician or Psychologist Administration of Entire Neurofunctional Testing).The physician administered the entire tests, therefore the correct code is 70555 not code 70554. In parenthesis, under the code, there is a note that states that code 96020 can only be used with code 70555.

Question 2

The patient is being evaluated for spinal curvature problems of the lower back. She has been sent to the radiologist for a set of spinal x-rays. The radiologist takes x-rays from 4 different views of her spine (standing straight, bending forward and from each side) along with three additional views. These films are sent to the patient's PCP for interpretation and report. What code should the radiologist report?

Accepted Answer

The only code that the radiologist should report would be 72114 (Radiologic Examination, Spine, Lumbosacral; Complete, including Bending Views, Minimum of 6 Views) with modifier -TC appended. Modifier -TC indicates that the procedure consisted of taking the x-rays only and not the interpretation of the x-rays. The radiologist sent the x-rays to the patient's PCP for interpretation; therefore the only part of this service that was provided was the technical portion.

Question 3

The patient was given an MRA of the pelvis with and without contrast material. What is the correct code for the procedure?

Accepted Answer

The correct code for the procedure is 72198 (Magnetic Resonance Angiography, Pelvis, With or Without Contrast Materials). All of the other codes listed in the question are used for a magnetic resonance imaging (MRI) not a magnetic resonance angiography (MRA).

Question 4

A 38-year-old female patient with severe endometriosis received a CT scan of the pelvis and the abdomen with and without contrast. What radiology code should be reported?

Accepted Answer

The radiology code that should be reported is 74178 (Computed Tomography, Abdomen and Pelvis; Without Contrast Material in One or Both Body Regions, Followed by Contrast Materials and Further Sections in One or Both Body Regions).74178 is the only code that needs to be reported..

Question 5

A 65-year-old female patient with atherosclerosis receives an abdominal aortography via serialography. The patient's cardiologist reviews and interprets the findings. What is the appropriate code for this service?

Accepted Answer

The appropriate code for this service is 75625 (Aortography, Abdominal, by Serialography, Radiological Supervision and Interpretation). Code 75625 does not need to be appended with the modifier -26 because modifier -26 indicates radiological supervision and interpretation. Code 75625 already states that the service was just for the supervision and interpretation. To append modifier -26 would be repetitive.

Question 6

Radiation oncology codes consist of a specialized portion of radiology codes that are used to report which of the following?

Accepted Answer

Radiation oncology codes consists of a specialized portion of radiology codes that are used to report radiological services that are used to deliver radiation treatments to tumors. Radiation oncology services are provided by a multi-disciplinary group of physicians, physicists, computer scientists, radiotherapy technologists, nutritionists and social workers. These professionals work together to create and deliver radiation treatments for tumors.

Question 7

ONCOLOGY CLINIC NOTE PATIENT NAME: Watts, Douglas
AGE: 15
DATE: 07/08/2014
DIAGNOSIS: Mantle Cell Lymphoma in the Neck
TREATMENT: Clinical Treatment Planning stage I including simulation of treatment
The patient was recently diagnosed with mantle cell lymphoma in the neck. He was seen in the clinic today for the first stage of clinical treatment planning. The patient's first step is to start radiation treatments. Due to the mild nature of the lymphoma, planning will focus on a single treatment area, with a single radiation port and no blocking. The primary care oncologist agrees that this focus is the best way to manage the malignancy before it progresses. No further aggressive treatments are necessary at this time. The patient and his family also agree that this will be a sufficient means of treatment at this time. Simple simulation of single treatment area was completed and the treatment plan seems sufficient.
The patient is scheduled to return to the clinic in two days, after dosimetry calculations have been completed and the total length of time for the radiation treatment has been calculated.
What is the correct code for this service?

Accepted Answer

The correct code for this service is 77261(Therapeutic Radiology Treatment Planning; Simple). This procedure is considered simple because the planning focused on a single treatment area and encompassed only a single port and no blocking. Other levels of planning may consist of more extensive treatments such as treatments for more aggressive forms of cancer.

Question 8

ONCOLOGY CLINIC NOTE PATIENT NAME: Watts, Douglas
AGE: 15
DATE: 07/10/2014
DIAGNOSIS: Mantle Cell Lymphoma in the Neck
TREATMENT: Dosimetry
A physician recommends clinical treatment planning, simple simulation of treatment, basic radiation dosimetry calculations (including central axis depth calculation, TDF, NSD, gap calculation, off-axis factor, and calculation of non-ionizing radiation surface) and depth dosing during clinical treatment planning. The amount of radiation is calculated and blocked to protect the remaining healthy tissues in the neck, shield the rest of the body from radiation, determine the dosage delivery and fractionate the radiation into treatments. The patient is scheduled to receive three treatments (once per week for the first two weeks) and once per month for the next three months. An simple treatment device delivers the required dosage to the port.
What is the correct code for this procedure?

Accepted Answer

The correct codes for the service are: 77300 (Basic Radiation Dosimetry Calculations) and 77332, mod-51 (Design and Construction of the Treatment Device). Modifier -51 needs to be included on the claim to indicate that the procedure was a multiple procedure performed on the same date of service.

Question 9

A young woman with right lower abdominal pain and history of ovarian cysts is ordered to have a transvaginal ultrasound to rule out ovarian cyst as the cause of her pain. What is the correct CPT code for this diagnostic ultrasound?

Accepted Answer

76830 is the correct code for nonobstetrical transvaginal ultrasound.
Code 76801 is incorrect because this code is for an obstetrical ultrasound. Codes 76856 and 76857 are incorrect because these codes are not for a transvaginal ultrasound; they are for a pelvic ultrasound.

Question 10

A pregnant woman needs to have a fetal echocardiogram performed. This will be done in real time with image documentation (2D) with M-mode recording. What is the correct code for this procedure?

Accepted Answer

76825 is the correct code for fetal echocardiography in real time with image documentation (2D) with M-mode recording.
Code 76820 is incorrect because this code is for fetal Doppler velocimetry. Code 76826 is incorrect because this code is for a follow-up or repeat fetal echocardiogram and code 76827 is incorrect because this code is for fetal Doppler echocardiography with pulsed wave and/or continuous wave with spectral display.

Question 11

A patient needs to have an epidural and, due to compressed discs, this procedure is done under fluoroscopic guidance. What is the correct code for this type of fluoroscopic procedure?

Accepted Answer

77003 is the correct code for fluoroscopic guidance and localization of needle or catheter tip for spine or paraspinous diagnostic or therapeutic injection procedures (epidural or subarachnoid).
Code 77002 is incorrect because this code is for fluoroscopic guidance for needle placement (biopsy, aspiration, injection, localization device). Code 77011 is incorrect because this code is for computed tomography guidance for stereotactic localization. Code 77012 is incorrect because this code is for computed tomography guidance for needle placement, radiological supervision and interpretation.

Question 12

A patient undergoes magnetic resonance guidance for needle placement for placement of a localization device. What is the correct code for this procedure?

Accepted Answer

77021 is the correct code for magnetic resonance guidance for needle placement (e.g., for biopsy, needle aspiration, injection, or placement of localization device) radiological supervision and interpretation.
Codes 77011 and 77012 are incorrect because these codes are for computed tomography guidance procedures. Code 77022 is incorrect because this code is for magnetic resonance guidance for, and monitoring of, parenchymal tissue ablation.

Question 13

A physician orders a fluoroscopic guidance for needle placement to aspirate a small, possibly malignant lesion on a patient's liver. What is the code for this type of radiologic guidance procedure?

Accepted Answer

77002 is the correct code for fluoroscopic guidance for needle placement (e.g., biopsy, aspiration, injection, localization device).
Code 77001 is incorrect as this is an add-on code for fluoroscopic guidance for central venous access device placement. Code 77003 is incorrect because this code is for fluoroscopic guidance and localization of needle or catheter tip for spine or paraspinous diagnostic or therapeutic injection procedures. Code 77011 is incorrect because this code is for computed tomography guidance for stereotactic localization.

Question 14

A 56-year-old woman is undergoing a bilateral screening mammogram. What is the correct code for this procedure where there is computer-aided detection?

Accepted Answer

77057, 77052 is the correct code sequence for this procedure. 77057 is the correct code for a screening mammography, bilateral with 2-view film study of each breast and 77052 is the correct code for computer-aided detection during a screening mammography.
Code 77054 is incorrect because this code is for a mammary ductogram or galactogram. Code 77056 is incorrect because this is for a bilateral mammography, but not for a screening mammography. Code 77057 is correct, but alone does not include computer-aided detection and requires the additional code to indicate this further testing.

Question 15

A patient has a breast lump that has been assessed by her gynecologist, who scheduled her for a bilateral mammogram. What is the correct code for this procedure, given that it is not a screening mammogram, because there is a known problem?

Accepted Answer

77056 is the correct code for bilateral mammography.
Code 77055 is incorrect because this code is for a unilateral mammography. Code 77057 is incorrect because this code is for a bilateral screening mammography. Code 77058 is incorrect because this code is for unilateral magnetic resonance imaging of the breast with/without contrast material.

Question 16

A patient has to have a right-sided digital breast tomosynthesis. What is the correct code for this procedure?

Accepted Answer

77061 is the correct code for a unilateral digital breast tomosynthesis.
Code 77058 is incorrect because this code is for unilateral magnetic resonance imaging. Code 77062 is incorrect because this code is for bilateral digital breast tomosynthesis. Code 77063 is incorrect because this code is for a bilateral screening digital breast tomosynthesis.

Question 17

A patient is given an order for bone age studies. What is the correct CPT code for this procedure?

Accepted Answer

77072 is the correct code for bone age studies.
Code 77073 is incorrect because this code is for bone length studies. Code 77074 is incorrect because this is for radiologic examination, osseous survey. Code 77076 is incorrect because this is the code for radiologic examination, osseous survey for an infant.

Question 18

What is the correct code for computed tomography for a bone mineral density study of the axial skeleton?

Accepted Answer

77078 is the correct code for computed tomography, bone mineral density study, one or more sites of the axial skeleton.
Code 77077 is incorrect because this code is for a joint survey. Code 77080 is incorrect because this code is for a dual-energy X-ray absorptiometry (DXA), bone density study. Code 77086 is incorrect because this code is for vertebral fracture assessment via DXA.

Question 19

A patient is scheduled for a vertebral fracture assessment via dual-energy X-ray absorptiometry (DXA). What is the correct code for this procedure?

Accepted Answer

77086 is the correct code for vertebral fracture assessment via dual-energy X-ray absorptiometry (DXA).
Code 77078 is incorrect because this code is for computed tomography. Code 77080 is incorrect because this code is for a DXA but is for a bone density study of one or more sites of the axial skeleton, not specifically to assess for vertebral fracture. Code 77084 is incorrect because this code is for a magnetic resonance imaging for bone marrow blood supply.

Question 20

A patient needs to have static liver imaging performed with vascular flow. What is the correct CPT code for this procedure?

Accepted Answer

78202 is the correct code for static liver imaging with vascular flow.
Code 78195 is incorrect because this code is for lymphatics and lymph nodes imaging. Code 78199 is incorrect because this code is for unlisted hematopoietic, reticuloendothelial and lymphatic procedure, diagnostic nuclear medicine. Code 78201 is incorrect because this code is for static liver imaging without vascular flow.

Quiz 12: Radiology