When a gastrointestinal procedure, such as an endoscopic retrograde cholangiopancreatography, is performed and includes radiological supervision and interpretation, who can report the radiology services? For example, if the images are sent to a radiologist for review after the case has ended, would it be appropriate for the radiologist to report the supervision and interpretation service? By definition, it seems that for supervision and interpretation, the provider must be in attendance for the intraoperative session in order to report the service. The CPT codes in question are code 43260 (REVISED IN 2014), Endoscopic retrograde cholangiopancreatography (ERCP); diagnostic, with or without collection of specimen(s) by brushing or washing (separate procedure) and code 74328 , Endoscopic catheterization of the biliary ductal system, radiological supervision and interpretation. ...
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Article Overview
This article addresses a coding question about radiology supervision and interpretation associated with a gastrointestinal endoscopic procedure, using ERCP as the example. It discusses the distinction between being present for supervision versus later interpretation, and it notes how reporting may be divided when different physicians handle those parts of the service. The piece is relevant to coding staff, radiology practices, gastroenterology practices, and compliance reviewers who work with CPT reporting.
Why This Topic Matters
Accurate reporting of combined procedural and radiology services affects claim integrity and helps avoid duplicate or inappropriate billing when more than one physician is involved.
What You Will Learn
- How radiology supervision and interpretation is framed in the context of a gastrointestinal endoscopic procedure.
- The difference between supervision during the procedure and later review of images.
- How split reporting of a radiology service may be discussed in multi-physician scenarios.
- The general relevance of this topic to CPT reporting and compliance.
Who Should Read This
- Medical coders
- Radiology billing staff
- Gastroenterology billing staff
- Compliance auditors
- Physician office staff
Codes Discussed
Modifiers Discussed
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