Radiology, Pathology, and Laboratory

1
Chapter 11

• Radiology, Pathology, and Laboratory

2
Radiology Specialty Areas

• Radiation therapy
• Nuclear medicine
• Ultrasound
• Computed tomography
• Magnetic resonance imaging

3
CPT Sections of Radiology

• Diagnostic radiology (diagnostic imaging)
• Diagnostic ultrasound
• Radiation oncology
• Nuclear medicine

4
Radiology Modifiers

• -22
• -26
• -51
• -52

• -53
• -59
• RT or LT

5
Diagnostic Radiology

• Includes
• X-ray
• CAT scan
• Magnetic resonance imaging (MRI)
• Magnetic resonance angiography (MRA)

6
Diagnostic Ultrasound

• Located in the index under ultrasound
• Types
• A mode
• M mode
• B scan
• Real-time scan

7
Radiation Oncology

• Internal radiation
• Brachytherapy
• Applying radioactive material through wires,
  seeds, tubes, or needles
• External radiation
• Delivers radiation from external source through
  patients skin

8
Nuclear Medicine

• Administration of radioisotopes including
• Bone scans
• Cardiac scans
• Thallium 201 scans
• Lung scans
• Renal scans
• Thyroid scans

9
Pathology and Laboratory

• Organ or disease panels
• Drug testing
• Therapeutic drug assay
• Evocative suppression testing

• Consultations
• Urinalysis
• Chemistry
• Hematology

10
Pathology and Laboratory (cont.)

• Immunology
• Transfusion medicine
• Microbiology
• Anatomic pathology
• Cytopathology

• Cytogenetic studies
• Surgical pathology
• Transcutaneous procedures
• Reproductive medicine

11
Physician Billing Requirements

• Coder must determine which part(s) of the test
  was performed.
• Verify test performed is a waived test or a
  physician-performed microscopy test.

12
Screening

• Qualitative
• Tests that detect the presence of a particular
  analyte, constituent, or condition (What is
  present?)
• Quantitative
• Measures specific amount of an analyte in a
  sample (How much is present?)

13
Common Pathologyand Laboratory Modifiers

• -53
• -59
• -90
• -91

• -22
• -26
• -32
• -52

14
CLIA

• All laboratories must comply with requirements
  and obtain a certificate.
• Designated four levels of testing
• Waived tests
• Physician-performed microscopy
• Moderate complexity
• High complexity

15
Pathology and Laboratory

• Organ or disease panels
• Group of tests routinely performed on one blood
  sample
• Evocative suppression testing
• Determine baseline level of chemicals after
  taking prescribed substance

16
Pathology and Laboratory (cont.)

• Chemistry
• Quantitative testing
• Hematology and coagulation
• Procedures on blood or bone marrow
• Immunology
• Testing immune system components and functions

17
Pathology and Laboratory (cont.)

• Transfusion medicine
• Report blood typing, transfusions, and antibody
  identification
• Microbiology
• Identification of types of bacteria
• Anatomic pathology
• Autopsy

18
Pathology and Laboratory (cont.)

• Cytopathology
• Pap smears, needle aspirations, and chromosome
  testing
• Surgical pathology
• Examination of specimens removed during surgery