Q: What is the appropriate code to report a urologic examination when Digital X-Ray Tomosynthesis (DTS) is used? Several manufacturers produce DTS systems that integrate into fixed or mobile radiographic units or into combination radiographic and fluoroscopic systems to enable tomosynthesis imaging in supine/prone or erect patient positions.
It is appropriate to report CPT® code 74400 (Urography (pyelography), intravenous, with or without KUB, with or without tomography) when an intravenous contrast excretion exam using a digital X-ray tomosynthesis (DTS) system is performed.
DTS is a series of low-dose projections acquired during a linear sweep of the x-ray tube along the indicated anatomy, while the digital detector remains stationary. Acquired projection data are reconstructed into an array of successive thin-slice images throughout the entire anatomy’s depth as compared to a linear tomography sweep which produces a single thick-slice image. DTS thin-slice images are comparable to standard radiography images, but without any overlapping structures from out-of-plane anatomy that impair interpretation on conventional projection images.1
Q: The ACR published in the March/April 2014 ACR Radiology Coding Source that it was appropriate to report 73550 with modifier -52 to describe a one-view evaluation of the femur for an atypical femur fracture assessment that delivers dual-energy bone density measurements in a single-sweep. How should this be reported now that code 73550 has been deleted?
A one-view evaluation of the femur for an atypical femur fracture assessment that delivers dual-energy bone density measurements in a single-sweep, as of 2016, is appropriately reported with code 73551 Radiologic examination, femur; one view. In 2016, the femur code 73550, previously recommended, was deleted and replaced by two codes that describe the number of views: 73551 a one-view study, and 73552 a two-view study.