coding
rendered images. Concurrent means
active participation in and monitoring of
the reconstruction process that includes1:
1. Design of the anatomic region that is to
be reconstructed
2. Determination of the tissue types and
actual structures to be displayed (eg,
bone, organs, and vessels)
3. Determination of the images or cine
loops that are to be archived
4. Monitoring and adjustment of the 3D
work product
Concurrent does not relate to the definitions for general, direct, and personal
supervision that have been established by
the Centers for Medicare and Medicaid
Services (CMS).
Nuclear Thyroid Studies
Three new codes have been established
for thyroid uptake and imaging. Code
78012 includes uptake only, code 78013
includes imaging only, and code 78014
includes uptake and imaging.
• 78012: Thyroid uptake, single or multiple
quantitative measurement(s) (including
stimulation, suppression, or discharge,
when performed)
• 78013: Thyroid imaging (including vascular flow, when performed);
• 78014: . . . with single or multiple
uptake(s) quantitative measurement(s)
(including stimulation, suppression, or
discharge, when performed)
Also, these seven existing codes will be
deleted:
• 78000: Thyroid uptake; single determi-
nation
• 78001: . . . multiple determinations
• 78003: . . . stimulation, suppression or
discharge (not including initial uptake
studies)
Nuclear Parathyroid Studies
New codes have been created to better
reflect clinical practices for parathyroid
scans. The existing code for parathyroid
scan (78070) has been revised, and two
new codes have been added.
• 78070: Parathyroid planar imaging
(including subtraction, when performed);
• 78071: . . . with tomographic (SPECT)
• 78072: . . . with tomographic (SPECT),
and concurrently acquired computed
tomography (CT) for anatomical localization
Neurofunctional Testing
Procedure code 96020 is used to report
neurofunctional testing during functional MRI. This code has also been
revised to reflect that the testing may be
performed by other qualified healthcare
professionals.
Editorial Revisions
The codes for ultrasound of infant hips
(76885-76886) have been revised to
reflect that manipulation can be performed by other qualified healthcare
professionals as well as physicians. The
computer-aided (CAD) detection codes
(77051-77052) have been revised to
remove the reference to physician
review. It is unclear at this point if this
change will impact how and if facilities
bill for CAD services. Finally, the code
for joint stress application (77071) has
been revised to indicate the stress can be
applied by other qualified healthcare
professionals as well as by physicians.
The greatest number of radiology
changes for 2013 occur for interventional
services.
Overall Supervision and
Interpretation Guidance
The paragraph on supervision and inter-
pretation (S&I) services in the “Radiology
Guidelines” section of the CPT® manual
has been significantly revised and
expanded to reflect the trend toward
bundling of S&I services. It now reads
as follows2:
Imaging may be required during the per-
formance of certain procedures or certain
imaging procedures may require surgical
procedures to access the imaged area.
Many services include image guidance,
which is not separately reportable and is so
stated in the descriptor or guidelines.
When imaging is not included in a surgical
procedure or procedure from the Medicine
section, image guidance codes or codes
labeled “radiological supervision and
interpretation” may be reported for the
portion of the service that requires imag-
ing. Both services require image documen-
tation and radiological supervision, inter-
pretation, and report services require a
separate interpretation.
Also in the “Radiology Guidelines”
section, the paragraph on written
report(s) has been revised to indicate the
report must be signed by the interpreting
individual rather than the interpreting
physician. Again, this revision does not
change any existing non-physicians’
scope of practice, but rather allows for
more accurate reporting of performed
services.
Head and Neck Catheterization
and Angiography
The biggest change for 2013 is the complete overhaul of the head and neck
catheterization and imaging codes.
There are eight new all-in-one codes for
head and neck catheter placement. Like
the renal artery codes that were introduced last year, these codes include both
the catheterization and the diagnostic
imaging (arteriography S&I). All of
these codes include the work of accessing the vessel, placement of catheter(s),
