AAPC - American Academy of Professional Coders Radiology Section Guidelines Questions and Answers

Question 1

A radiologist, who is an independent contractor, interprets a chest X-ray that was performed at a hospital. The hospital owns the equipment and its employee performed the technical portion of the service. How should the radiologist report their service?

Accepted Answer

Report the CPT code with modifier 26

Answer

Modifier 26 is used to indicate that only the professional component of a procedure was performed. In this scenario, the radiologist only provided the interpretation and report (the professional service), while the hospital provided the equipment, supplies, and technician (the technical component). Therefore, appending modifier 26 to the appropriate CPT code is correct.

Question 2

A patient undergoes a CT scan of the abdomen without contrast, followed by an additional scan of the same area with IV contrast during the same session. Which of the following best describes how this should be coded?

Accepted Answer

Use a single CPT code that describes a CT scan performed 'without contrast, followed by with contrast'.

Answer

CPT provides specific codes for radiological studies performed without contrast, with contrast, and 'without, followed by with contrast'. When both types of scans are performed on the same anatomical area during the same encounter, the single combination code that describes both services should be used. It is incorrect to bill for the two separate scans.

Question 3

In the CPT manual, what does the designation '(separate procedure)' following a code description imply?

Accepted Answer

The procedure is normally part of a more extensive service and should not be billed separately if a related, larger procedure is performed.

Answer

The '(separate procedure)' designation means the procedure is often an integral component of a larger service. It should not be reported separately when performed along with another procedure in an anatomically related region. It can be reported if it is the only procedure performed or if it is distinct and unrelated to other procedures performed during the same encounter.

Question 4

An interventional radiologist performs a diagnostic renal angiogram. They access the arterial system via the right common femoral artery, advance the catheter into the aorta, and then selectively guide it into the left renal artery for imaging. How is the catheter placement best described?

Accepted Answer

Selective catheter placement

Answer

Non-selective catheter placement occurs when the catheter remains in the initial vessel accessed or is placed only into the aorta. Selective catheter placement occurs when the catheter is advanced beyond the initial vessel or aorta into a branch vessel. Since the catheter was moved from the aorta into the renal artery, it is a selective placement.

Question 5

A physician in a freestanding imaging center must provide which level of supervision for a CT scan of the lumbar spine with contrast?

Accepted Answer

Direct supervision

Answer

According to CMS guidelines, certain complex diagnostic tests, especially those involving contrast material, require 'direct supervision'. Direct supervision means the physician must be present in the office suite and immediately available to provide assistance, though they do not need to be in the room where the procedure is performed.

AAPC - American Academy of Professional Coders Practice Test

AAPC - American Academy of Professional Coders Practice Test

AAPC - American Academy of Professional Coders Radiology Section Guidelines Questions and Answers