the process of producing a picture or record
-graphy
radiographic imaging of a joint (with contrast media)
arthrography
X-ray of bile ducts and pancreatic ducts using contrast medium
cholangiopancreatography
a radiographic examination of the bile ducts with the use of a contrast medium
cholangiography
radiographic imaging of the bladder
cystography
radiographic recording of the lacrimal sac or tear duct sac
dacryocystography
radiographic recording of the duodenum or first part of the small intestine
duodenography
ultrasonic procedure used to evaluate the structure and motion of the heart
echocardiography
A radiographic study demonstrating the intracranial fluid containing spaces of the brain.
encephalography
radiographic recording of the epididymis
epididymography
radioactive examination of the liver
hepatography
X-ray imaging of the uterus and fallopian tubes after injection of contrast material.
hystersalpingography
radiographic recording of the larynx
laryngography
radiographic examination of lymph glands and lymphatic vessels after an injection of a contrast medium
lymphangiography
a radiographic study of the spinal cord after the injection of a contrast medium through a lumbar puncture.
myelography
x-ray imaging of the renal pelvis and urinary tract
pyelography
radiography of salivary glands and ducts
sialography
radiographic recording of the sinus or sinus tract
sinography
radiographic recording of the spleen
splenography
x-ray imaging of the urinary tract after injection of contrast material; pyelography
urography
radiographic imaging of a vein (after injection of contrast media)
venography
radiographic recording of the seminal vesicles
vesiculography
an x-ray procedure that allows the visualization of internal organs in motion using real-time video.
fluoroscopy
radiology technique that uses magnetism, radio waves, and a computer to produce images of body structures.
magnetic resonance imaging (MRI)
process of creating a two-dimensional image of a plane through a 3D object.
Tomography
picture made by a tomograph
tomogram
instrument that uses x-ray to produce images through planes (slices) of the body
tomograph
statistical analysis of biological data
biometry
from front to back
anteroposterior (AP)
path of an x-ray beam (from x to y)
projection
how the patient is placed (differs from projection)
position
of or relating to the head
cephalic (superior)
toward the lower part of the body
caudal (inferior)
the plane dividing the body into equal right and left halves
median (midsagittal) plane
divides the body into front and back
coronal (frontal) plane
any horizontal plane passing through the body and dividing it into superior and inferior portions
transverse (horizontal) plane
toward the front
anterior (ventral)
toward the back
posterior (dorsal)
toward the outside, away from the median plane
lateral
closest to the trunk of the body
proximal
farthest from the trunk of the body
distal
from back to front
posteroanterior (PA)
closest to
“Right lateral” is an x-ray position meaning the pt’s right side is ________ ________ the film.
lying on the back (dorsal)
supine
lying on the stomach (ventral)
prone
in radiology, an x-ray taken of a recumbent subject with a horizontal x-ray beam.
decubitus
body is rotated, falls between full anteroposterior and full posteroanterior
oblique
pt starts in left lateral position, then tips right side 45 degree forward
left anterior oblique (LAO)
pt starts in right lateral position, then tips left side 45 degrees forward
right anterior oblique (RAO)
pt starts in left lateral position, then tips right side 45 degrees backward
left posterior oblique (LPO)
pt starts in right lateral position, then tips left side 45 degrees backward
right posterior oblique (RPO)
central ray “skims” the profile of the subject.
tangential projection
longitudinal angulation of the x-ray beam
axial projection
costly photoelectric x-ray procedure using specially sensitized screens that give higher resolution on the edges of bone and better visualization of soft tissue structures.
xeroradiography
aka combination coding; a code from the Radiology section must be added to a code from another section in order to fully describe the procedure.
component coding
vein or artery
“With contrast” is material injected into a ________ or ________.
does not
Oral or rectal contrast does/does not qualify for “with contrast.”
injection
“With contrast” implies that the ________ service is a part of the code and is not reported separately.
If code description does not include “with contrast,” code with 99070 or a HCPCS code.
How is contrast material coded?
Medically Unlikely Edits
MUEs
Diagnostic Radiology
plain x-rays, CAT or CT scanning, MRI, MRA, and angiography are included in what Radiology subsection?
a cavity or passage in a tubular organ
lumen
-52 (Reduced Services)
If fewer than the total number of views specified are taken, what modifier is used?
“Other Procedures.” In Index under Fluoroscopy, Hourly
Where do you find codes for a fluoroscopy performed by a radiologist assisting a nonradiologic physician
Amplitude.
What does the “A” stand for in A-mode ultrasound?
technique used to map structure outlines; one-dimensional image.
A-mode ultrasound
Motion
What does the “M” stand for in M-mode ultrasound?
technique used to display movement of a structure; displays one-dimensional image.
M-mode ultrasound
Brightness
What does the “B” stand for in B-scan?
technique used to display movement of tissues and organs. aka “grayscale ultrasound.” Displays two-dimensional image.
B-scan ultrasound
technique used to display both structure and motion of organ and tissue; displays a two-dimensional image.
real time scan
three; extent
Ultrasound codes are located in ________ places in the CPT manual, and are often divided based on ________.
1. Radiology section, Diagnostic Ultrasound subsection, 765xx
2. Medicine section, Non-Invasive Vascular Diagnostic Studies, 938xx
3. Medicine section, Echocardiography, 933xx
2. Medicine section, Non-Invasive Vascular Diagnostic Studies, 938xx
3. Medicine section, Echocardiography, 933xx
What are the three locations in the CPT manual that ultrasound procedures can be found?
A physician who specializes in minimally invasive procedures with the use of various radiologic techniques
interventional radiologist
Handheld device that sends and receives ultrasound signals
transducer
ultrasound
sonography
a study that uses sound for detection of blood flow within the vessels
Doppler ultrasound
application of radiation to tumor site for treatment of cancerous tumors
radiation oncology
E/M Consultation code (inpatient or outpatient)
How is the initial consultation for radiation oncology coded (prior to the decision to treat)?
planning and simulation
Clinical Treatment Planning of radiation oncology consists of ________ and ________.
Simple, Intermediate, Complex
What are the three types of clinical treatment plans?
Simple, Intermediate, Complex, 3D
What are the four levels of simulation?
service of determining treatment areas and placement of ports for radiation treatment; does not include administration of radiation.
Simulation
Code again as a new simulation.
If a change is made in the field of treatment and a new simulation is performed, how is this coded?
“Radiation Therapy” or specific service such as “Field Set-up.”
What do you reference in the Index to locate Clinical Treatment Planning?
Medical Radiation, Physics, Dosimetry, Treatment Devices, and Special Service
The codes in this subheading represent the decision-making services of the physician regarding the type of treatment, dose calculation and placement, and development of the treatment device.
calculation of the radiation dose and placement
dosimetry
technical components
Radiation Treatment Delivery codes reflect ________ ________ only.
megaelectron volts (MeV)
The radiation energy delivered in radiation treatment is in units called what?
Grays
The radiation energy deposited in the patient’s tissue during radiation treatment is measured in what units?
1 Gray = 100 rads. 1 centigray (cGy) = 1 rad.
What is the ration of Gray to rad?
1. Amount of radiation delivered in MeV
2. areas treated
3. ports involved
4. blocks used
2. areas treated
3. ports involved
4. blocks used
To report radiation treatment delivery services, you need to know what four variables?
professional component
Radiation Treatment Management codes report the ________ ________ of radiation treatment only.
three
Code77427 is reported if there are ________ or more fractions beyond the original five radiation treatments.
Do not code; 6 or 7 total treatments is rounded down to five. 8 and up is rounded up to 10.
How are one or two fractions beyond a multiple of five radiation treatments coded?
Review of port films, dosimetry, treatment parameters.
Review of pt treatment setup
assessment of pt (E/M)
Review of pt treatment setup
assessment of pt (E/M)
What services are bundled into Radiation Treatment Management codes?
Port films
basic plan calculation at onset of treatment
complex planning at beginning of treatment
E/M code on first day of treatment (office visit or consult)
basic plan calculation at onset of treatment
complex planning at beginning of treatment
E/M code on first day of treatment (office visit or consult)
What services are NOT bundled into Radiation Treatment Management?
Management (professional component) is not coded; code only technical component code.
How is radiation treatment management coded for under 5 sessions?
False; diagnosis and treatment.
True or false: nuclear medicine is used for diagnosis only.
Code separately with therapeutic codes or HCPCS codes.
How is the radioactive material coded?
substances that emit radiation spontaneously; also called tracers
radionuclides
oral and intravenous
These two administration techniques are bundled into the administration of radiopharmaceuticals.
1. Code the drug.
2. Code the injection.
3. Code the imaging guidance/radiological supervision when appropriate.
2. Code the injection.
3. Code the imaging guidance/radiological supervision when appropriate.
For intra-arterial, intra-cavity, and intra-articular administration of radioparmaceuticals, what codes are needed?
V-codes (Chapter 17)
In what chapter do you find the diagnosis code for an x-ray as part of a preventive medicine for pre-operative exam?
Code as incidental finding, not as primary diagnosis.
How is it coded if a provider finds something unexpected on an x-ray?
Supervision and Interpretation
S&I stands for what?
Kidney, Ureter, and Bladder (common preoperative x-ray)
What does KUB stand for?
Fluoroscopy
This type of x-ray is used for catheter insertion or needle placement, and is a continuous x-ray displayed onto a screen.
Computer-aided detection (software used to interpret mammograms)
CAD
Dual energy X-ray absorptiometry (used to determine bone density)
DEXA
Mammography and PET scans.
What are two common types of HCPCS Level II codes used during radiology?
radiography of an organ in motion (eg a beating heart)
cineradiography
any therapy administered at a distance from the body (eg radiation)
teletherapy
angiography
radiographic image of the blood vessels using contrast material
