Radiology Cross Coder Essential links from CPT® codes to ICD-9-CM and HCPCS codes 2013 00 RCC TOC.fm Page 1 Friday, N ovem ber 18, 2011 4:30 PM Contents Introduction. ............................................................... i Other Radiologic Guidance .....................................452 Format ......................................................................... i Breast, Mammography .............................................454 Icon Key ..................................................................... ii CPT Codes .................................................................. ii Bone/Joint Studies ..................................................457 Code Links ................................................................ iii ICD-9-CM Diagnostic Codes ...................................... iii Radiation Oncology .................................................467 ICD-9-CM Procedure Codes ...................................... iv Clinical Treatment Planning (External and Internal Sources) ..............................................467 HCPCS Level II Codes ............................................... iv Medical Radiation Physics, Dosimetry, Summary .................................................................. vii Treatment Devices, and Special Services ..........467 Diagnostic Radiology (Diagnostic Imaging) ............... 1 Stereotactic Radiation Treatment Delivery ...............478 Head and Neck ........................................................... 1 Radiation Treatment Delivery ..................................480 Chest ........................................................................ 70 Neutron Beam Treatment Delivery ..........................486 Spine and Pelvis ........................................................ 86 Radiation Treatment Management ...........................489 Upper Extremities ................................................... 184 Proton Beam Treatment Delivery .............................489 Lower Extremities ................................................... 220 Hyperthermia ..........................................................490 Abdomen ................................................................ 266 Clinical Intracavitary Hyperthermia ........................492 Gastrointestinal Tract .............................................. 284 Clinical Brachytherapy ............................................493 Urinary Tract .......................................................... 310 Nuclear Medicine. ...................................................503 Gynecological and Obstetrical ................................. 328 Diagnostic—Endocrine System. ..............................503 Heart ....................................................................... 330 Diagnostic—Hematopoietic, Reticuloendothelial, Vascular Procedures ................................................ 335 and Lymphatic System. ....................................504 Other Procedures .................................................... 382 Diagnostic—Gastrointestinal System. ......................511 Diagnostic Ultrasound ........................................... 386 Diagnostic—Musculoskeletal System. .....................520 Head and Neck. ...................................................... 386 Diagnostic—Cardiovascular System. .......................524 Chest ...................................................................... 398 Diagnostic—Respiratory System. .............................548 Abdomen and Retroperitoneum .............................. 399 Diagnostic—Nervous System. .................................552 Spinal Canal ............................................................ 404 Diagnostic—Genitourinary System. .........................566 Pelvis ...................................................................... 406 Diagnostic—Other Procedures. ...............................569 Genitalia ................................................................. 437 Therapeutic. ............................................................569 Extremities .............................................................. 439 Glossary. .................................................................571 Ultrasonic Guidance Procedures ............................. 440 Other Procedures .................................................... 448 Neoplasm Table. .....................................................579 Radiologic Guidance .............................................. 451 Fluoroscopic Guidance ........................................... 451 Computed Tomography Guidance .......................... 451 Magnetic Resonance Guidance ................................ 452 © 2011 Optum CPT © 2011 American Medical Association. All Rights Reserved. Introduction OptumInsight is pleased to present the 2012 Radiology Cross Coder. Format The popularity of similar publications, such as Surgical Cross Coder, An understanding of this book’s format allows users to easily indicates that a one-stop reference for radiology codes is valuable to navigate its content. Information within the main section ties to the coders. Fully comprehensive, Radiology Cross Coder links more than CPT book and the codes are presented in the same numeric order as 600 CPT radiology codes to corresponding ICD-9-CM diagnosis, the radiology section. ICD-9-CM procedure, CPT surgery, and HCPCS Level II codes. OptumInsight believes that professional coders working in Sections physician offices, clinical outpatient, hospital, as well as payer Radiology Cross Coder provides linked information to the CPT code settings will embrace this reference. range 70010 to 79999. The codes are divided into the same sections and subsections as the radiology section of the CPT book. Radiology Cross Coder is based on the radiology section of Current For example, the diagnostic radiology section is further divided into Procedural Terminology® (CPT). Up-to-date CPT radiology codes anatomical subsections, such as head and neck, spine and pelvis, link to the following related medical coding systems: and abdomen. There are also sections for diagnostic ultrasound, • International Classification of Diseases, 9th Revision, Clinical radiation oncology, and nuclear medicine. Modification (ICD-9-CM) Codes and Code Ranges •. Healthcare Common Procedure Coding System (HCPCS) The data within each CPT code set of Radiology Cross Coder is presented as follows: All coding relationships in Radiology Cross Coder start with the • CPT code or code range surgery section of the CPT book presenting a general clinical picture of each surgery code. Pertinent radiology-related coding • CPT codes and descriptions relationships were carefully reviewed and screened for appropriate • CPT cross codes and descriptions information. • ICD-9-CM diagnostic codes and descriptions Certain radiology procedures such as chest x-rays are performed for • ICD-9-CM procedural codes and descriptions almost any diagnosis and are simply too numerous to list. In such instances, the associated diagnoses do not appear in Radiology Cross •. HCPCS Level II codes and descriptions Coder. For a discussion on secondary diagnosis codes, see the ICD-9-CM section later in this introduction. For example: Some CPT codes are omitted from the listing because consistent 70380 and reliable cross-links are almost impossible to establish. Unlisted 70380 Radiologic examination, salivary gland for calculus procedure codes are an obvious example. Certain types of add-on codes are also treated somewhat differently. These codes are Associated CPT Codes discussed in greater detail under the CPT Codes section later in this N/A introduction. Unlisted and add-on codes are listed with full ICD-9-CM Diagnostic descriptions in appendixes at the end of this publication. 526.9 Unspecified disease of the jaws As a coding reference, Radiology Cross Coder presents “most likely” 527.5 Sialolithiasis scenarios as derived from clinical information sources. However, 527.8 Other specified diseases of the salivary glands Radiology Cross Coder is not a substitute for ICD-9-CM, or any other 527.9 Unspecified disease of the salivary glands medical coding reference, and users are urged to regularly consult 784.2 Swelling, mass, or lump in head and neck all available sources. The absence of any specific code does not ICD-9-CM Procedural necessarily indicate that its association to the base procedure code is 87.09 Other soft tissue x-ray of face, head, and neck inappropriate. Assuming all rules of radiology coding are followed, HCPCS Level II Supplies & Services excepted diagnosis codes may prove appropriate to a specific code R0070 Transportation of portable x-ray equipment and scenario. personnel to home or nursing home, per trip to facility Radiology Cross Coder does not include coding rules or guidelines. or location, one patient seen Once again, the user is urged to consult the original coding R0075 Transportation of portable x-ray equipment and reference (e.g., CPT, ICD-9-CM, HCPCS Level II, etc.) or one of personnel to home or nursing home, per trip to facility several reputable medical coding instruction manuals. or location, more than one patient seen © 2011 Optum CPT © 2011 American Medical Association. All Rights Reserved. i Radiology Cross Coder 73085 782.2 Localized superficial swelling, mass, or lump V54.20 Aftercare for healing pathologic fracture of arm, unspecified 2 812.40 Closed fracture of unspecified part of lower end of humerus 2 V54.21 Aftercare for healing pathologic