Radiology: Supervision & Interpretation
Next slide: Radiology - supervision and interpretation.
This is been a perennial confusing topic and I was admitting to Alicia tonight that I had
been teaching for three years before I finally got this.
So I say that to make you feel ok if you don't get everything, you still can pass the exam,
you don't have to know everything.
This is definitely an area that confuses people.
Notice it says supervision and interpretation, not interpretation and report . That's why
these get confused.
So the question is "could you please illustrate with an example, preferably a problem of your
choice when radiation supervision interpretation codes are applicable.
So here's an example that Alicia found intravascular ultrasound of noncoronary vessel radiological
supervision and interpretation due to renal artery stenosis.
This came out of one of our workbook exercises.
When you look up the code in the index it points you to 75945 and when you read the
description of that in CPT intravascular ultrasound noncoronary vessel radiological supervision
and interpretation initial vessel.
Ok.
So what what is this supervision and interpretation?
Lets go to the next slide.
Here is a copy and paste of the guidelines in radiology on page 361 if you are using
the 2012 professional version that tells us what it is.
Go to your guidelines, ok?
And I call this two-code story - two codes are needed to tell the story for some radiological
procedures.
Years ago way before I started studying coding, apparently, there were these single codes
that told the story of say, I don't know...starting a catheter and manipulating up to a point
to inject dye and imaging . Really, that's two pieces, that's a surgical piece, right?
cutting into the patient and inserting and manipulating the catheter and then the radiology
piece.
And then what was happening, an interventional radiologist, is what they are called, would
do both pieces, that's why they are called an interventional radiologist.
But they didn't always do two pieces.
Sometimes you had a surgeon type guy doing the surgery piece and you had the radiologist
doing the supervision and interpretation piece.
So what they decided to do because it was different for every single situation how to
split the fee, they just said forget it, we are not going to let them share the CPT code,
we are going to have two CPT codes.
So one was for the surgical piece, when I say surgical, I don't mean like major surgery,
but cutting into the body inserting something or injecting dye.
The other piece was the radiology supervision and interpretation piece.
So whenever you see that phrase, that's all that means is that somebody inserting something
or injecting dye all that means is “I'm part of a two part code story”, if you did
the other part, code that too.
So with that in mind, let's read the official definition.
When a procedure is performed by two physicians, the radiologic portion of the procedure is
designated as radiological supervision and interpretation.
When a physician performs both the procedure and provides imaging supervision and interpretation,
a combination of procedure codes outside the 70,000 series and imaging supervision and
interpretation codes are to be used.
When they say outside the 70,000 series, they mean those surgery type codes.
The bottom line, S and I, supervision and interpretation, is not interpretation and
report, two different things.
So supervision and interpretation report is what starts us thinking "oh professional component,
modifier 26", that's a whole different issue.
Supervision and interpretation - part of a two code story.