Whitney Palmer

New CT Abdomen/Pelvis CPT Code Changes Cut Reimbursement

Published in the April 26, 2011, DiagnosticImaging.com

By Whitney L.J. Howell

As of Jan. 1, 2011, the Centers for Medicare & Medicaid Services (CMS) changed the way you code for abdomen and pelvis CT scans performed together. The new combined-code requirement slices reimbursement for these services in half.

Each time you run these scans together, for the same reason and on the same service date, you lose between $200-400 in reimbursement, depending upon whether the test requires a contrast agent. That’s a 50 percent payment reduction each time you scan for tumors, cancer or other such problems.

Although the original codes for abdomen and pelvis CT scans conducted separately still exist, CMS now mandates that services performed together at least 75 percent of the time must use one CPT code. Assigning one code in these instances is the agency’s way of eliminating what it considers double payments for similar scans conducted at the same time.

The American College of Radiology (ACR) has opposed the move for the past five years, citing concerns over lost reimbursement, potential confusion over using new codes correctly, and frustration that consideration wasn’t given to the physician time needed to read scans.

To read the remainder of the article online: http://www.diagnosticimaging.com/practice-management/content/article/113619/1850806

April 28, 2011 - Posted by wjpalmer | Healthcare | abdomen CT scans, American Academy of Professional Coders, American College of Radiology, Centers for Medicare & Medicaid Services, Katherine Abel, Kim Snyder, pelvis CT scans, radiology reimbursement, radiology reimbursement cuts, reimbursement for abdomen/pelvis CT scans, reimbursement for CT scans, Zotec Partners