Understand the Basics of Radiology Billing Codes

Basics of Radiology Billing Codes

To receive accurate insurance reimbursements it is important to have a detailed understanding of radiology billing codes. The Current Procedural Terminology (CPT) code range for radiology procedures is 70010-79999, which is maintained by the American Medical Association (AMA). This code range is further sub-divided into 7 groups namely, 

  1. 70010-76499: Diagnostic Radiology (Diagnostic Imaging) Procedures
  2. 76506-76999: Diagnostic Ultrasound Procedures
  3. 77001-77022: Radiologic Guidance
  4. 77046-77067: Breast, Mammography
  5. 77071-77092: Bone/Joint Studies
  6. 77261-77799: Radiation Oncology Treatment
  7. 78012-79999: Nuclear Medicine Procedures

Due to copyright limitations, it’s not possible to give a complete list of radiology billing codes here. In this article, we shared how this code range for radiology billing codes is sub-divided and the importance of every sub-division. 

  • 70010-76499 Diagnostic Radiology (Diagnostic Imaging) Procedures

The radiology code range 70010-76499 refers to Diagnostic Radiology (Diagnostic Imaging) Procedures. These codes are used to identify various diagnostic imaging tests and procedures that are performed in radiology departments, clinics, hospitals, and other healthcare facilities. Here’s a breakdown of the code range:

  • 70010-70319: Diagnostic Radiology of the Head and Neck
  • 71010-71035: Chest Radiology
  • 72010-72133: Radiologic Examination, Spine
  • 72191-72194: Magnetic Resonance (MR) Imaging, Spine
  • 72200-72295: Radiologic Examination, Upper and Lower Extremities
  • 73010-73090: Radiologic Examination, Abdomen
  • 73510-73660: Radiologic Examination, Bones and Joints
  • 74000-74775: Radiologic Examination, Gastrointestinal Tract
  • 75000-75574: Radiologic Examination, Genitourinary Tract
  • 76000-76499: Radiologic Examination, Miscellaneous

These codes are used to report services such as X-rays, computed tomography (CT) scans, magnetic resonance imaging (MRI), ultrasound, and other imaging tests. Each code corresponds to a specific type of imaging test and provides detailed information about the procedure that was performed.

  • 76506-76999 Diagnostic Ultrasound Procedures

The radiology code range 76506-76999 is designated for Diagnostic Ultrasound Procedures, which are non-invasive imaging techniques that use high-frequency sound waves to create images of internal organs and tissues in the body. This subcategory of radiology billing codes covers a wide range of procedures and exams that use ultrasound technology to diagnose and monitor various medical conditions. Some common procedures included in this code range are abdominal, pelvic, and trans-vaginal ultrasounds, as well as breast, thyroid, and scrotal ultrasounds. Other procedures may include obstetrical ultrasound, which is used to monitor fetal development during pregnancy, and vascular ultrasound, which is used to evaluate blood flow in arteries and veins.

The procedures covered in this code range can be performed on patients of all ages and are generally considered safe and non-invasive. They are often used to help diagnose a variety of conditions, such as liver disease, kidney stones, gallbladder disease, ovarian cysts, and uterine fibroids, among others. It’s important to note that each individual code within this range may have specific requirements and indications for use and that these codes may vary depending on the type and complexity of the exam being performed. Additionally, reimbursement rates for these codes may also vary based on a number of factors, including the provider’s location, the type of insurance being billed, and the specific procedure being performed.

  • 77001-77022 Radiologic Guidance

Radiologic guidance involves using imaging technology, such as X-rays, CT scans, or ultrasounds, to guide the placement of instruments or devices inside the body. This can include procedures like biopsies, injections, or catheterizations. The codes in the 77001-77022 range are used to report the physician or other qualified healthcare professional’s professional work involved in the radiologic guidance service. These codes are typically reported in addition to the code for the primary procedure being performed. The specific codes in this radiology billing codes range describe different types of radiologic guidance services, such as:

  • 77001: Fluoroscopic guidance for needle placement (e.g., biopsy, aspiration, injection, localization device)
  • 77002: Fluoroscopic guidance for central venous access device placement, and replacement (e.g., PICC)
  • 77003: Fluoroscopic guidance for vascular access, requiring percutaneous needle puncture (e.g., arterial, venous)
  • 77011: Computed tomography guidance for needle placement (e.g., biopsy, aspiration, injection, localization device)
  • 77012: Computed tomography guidance for placement of radiation therapy fields
  • 77013: Magnetic resonance guidance for needle placement (e.g., biopsy, aspiration, injection, localization device)
  • 77014: Computed tomography guidance for stereotactic localization
  • 77021: Magnetic resonance guidance for placement of radiation therapy fields
  • 77022: Ultrasound guidance for intraoperative procedures (e.g., biopsy, aspiration)

It’s important to note that these codes only describe the radiologic guidance service itself and do not include any supplies or equipment used during the procedure. Additional codes may be necessary to report the use of specific supplies or equipment.

  • 77046-77067 Breast, Mammography

The codes within this radiology billing codes range are used to describe different types of mammography procedures, which are used to screen for and diagnose breast cancer. Mammography is a type of imaging test that uses low-dose X-rays to produce images of breast tissue. The codes in this range differentiate between digital mammography (codes 77046-77057) and breast tomosynthesis (codes 77061-77067). Digital mammography uses X-rays to produce digital images of the breast tissue, while breast tomosynthesis is a newer type of mammography that uses a 3D imaging technique to create detailed images of the breast tissue.

These codes also differentiate between bilateral and unilateral mammography procedures. It’s important to note that the codes within this range are used to describe the technical component of the mammography procedure (i.e., the equipment and imaging process), but not the professional component (i.e., the interpretation of the images by a radiologist). The professional component is billed separately using different CPT codes. Overall, the codes within this range are essential for accurate billing and coding mammography procedures, which are critical for the early detection and diagnosis of breast cancer.

  • 77071-77092 Bone/Joint Studies

The procedures covered by these codes can include X-rays, computed tomography (CT) scans, magnetic resonance imaging (MRI) scans, and bone density tests. They are typically used to diagnose and evaluate conditions such as fractures, arthritis, bone tumors, osteoporosis, and other conditions that affect the bones and joints. Some of the codes in this range are specific to certain areas of the body, such as the spine or the pelvis, while others are more general and can be used for imaging studies of multiple joints or bones. 

It’s important to note that each code in this radiology billing codes range has its own specific requirements for documentation and reporting, so it’s important to ensure that the correct code is used for each procedure and that all necessary information is included in the documentation. Overall, the 77071-77092 code range is an important tool for radiologists and other medical professionals in the evaluation and diagnosis of bone and joint conditions, and the proper use and reporting of these codes is crucial for accurate billing and reimbursement.

  • 77261-77799 Radiation Oncology Treatment

The codes in this range cover a wide variety of radiation therapy techniques, including external beam radiation therapy, brachytherapy, and stereotactic radiosurgery. They also describe the delivery of radiation therapy using various modalities, such as photon beams, electron beams, and protons. These codes are used to report the planning and delivery of radiation therapy treatment, as well as any associated imaging, dosimetry, and management services. They also include codes for treatment devices and accessories, such as immobilization devices and compensators.

The codes in this radiology billing codes range are highly specific and must be used accurately to ensure proper reimbursement for services provided. They are typically reported along with other codes related to cancer treatment, such as chemotherapy administration codes and surgical procedure codes. They cover a wide range of services, including planning and delivery of radiation therapy, as well as associated imaging, dosimetry, and management services. Proper use of these codes is essential for accurate reimbursement and effective management of cancer treatment.

  • 78012-79999 Nuclear Medicine Procedures

Nuclear Medicine is a branch of medical imaging that involves the use of radioactive substances to diagnose and treat various conditions. Nuclear Medicine procedures are performed by administering a small amount of radioactive material to the patient, which is then detected by a special camera or scanner that creates images of the body’s internal organs and tissues. Nuclear Medicine procedures can help diagnose and treat a range of conditions, including cancer, heart disease, and neurological disorders. These procedures are often used to examine the functioning of organs and tissues, such as the heart, lungs, liver, and thyroid gland.

The codes in this range represent a wide variety of Nuclear Medicine procedures, such as PET scans, bone scans, thyroid scans, and cardiac stress tests. Some codes in this range may also be used to indicate the use of radiopharmaceuticals, which are radioactive substances used in Nuclear Medicine procedures. It is important to note that these codes are used to document the technical components of Nuclear Medicine procedures, such as the equipment used and the methods employed. They do not include the interpretation or analysis of the images produced, which are typically reported separately by a radiologist or other healthcare provider.

We hope that the above explanation about every sub-category is enough to have a basic understanding of radiology billing codes. The American Medical Association (AMA) updates these radiology billing codes on an annual basis to reflect changes in medical technology and practices. It’s important for healthcare providers to stay up-to-date with the latest coding changes to ensure accurate reporting of services and appropriate reimbursement. 

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