CPT code 76120 is for cine or video X-rays, a diagnostic imaging technique capturing moving images to assess dynamic bodily functions.
CPT code 76120 is used to describe cine or video x-rays. This code is specifically for the process of capturing x-ray images in a motion picture format, which allows healthcare providers to view dynamic processes within the body. This technique is often used to assess moving structures, such as the heart or joints, to better understand their function and diagnose any abnormalities. The cine or video x-ray provides a series of images that can be played back in sequence, offering a more comprehensive view than a single static x-ray image.
When dealing with CPT codes for complex body section x-rays and cine/video x-rays, it's important to consider the potential need for modifiers to ensure accurate billing and reimbursement. Here is a list of modifiers that could be applicable:
1. Modifier 26 (Professional Component): This modifier is used when the physician provides only the professional component of the service, such as the interpretation of the x-ray, and not the technical component.
2. Modifier TC (Technical Component): This modifier is used when billing for the technical component of the service, which includes the use of equipment and the technician's time, but not the physician's interpretation.
3. Modifier 59 (Distinct Procedural Service): This modifier may be necessary if the x-ray service is distinct or independent from other services performed on the same day. It helps to indicate that the procedures are not bundled together.
4. Modifier 76 (Repeat Procedure by Same Physician): If the x-ray procedure needs to be repeated on the same day by the same physician, this modifier is used to indicate that the repeat service was necessary.
5. Modifier 77 (Repeat Procedure by Another Physician): Similar to Modifier 76, this is used when the repeat procedure is performed by a different physician on the same day.
6. Modifier 91 (Repeat Clinical Diagnostic Laboratory Test): Although primarily used for laboratory tests, if applicable, this modifier indicates that a repeat test was performed on the same day for the same patient to obtain subsequent results.
7. Modifier 52 (Reduced Services): This modifier is used when a service or procedure is partially reduced or eliminated at the physician's discretion.
8. Modifier 53 (Discontinued Procedure): If the procedure is discontinued due to extenuating circumstances or those that threaten the well-being of the patient, this modifier is applicable.
9. Modifier 99 (Multiple Modifiers): When more than four modifiers are necessary to describe the service, this modifier is used to indicate that multiple modifiers apply.
These modifiers help clarify the specifics of the service provided and ensure that the billing accurately reflects the work performed. Proper use of modifiers can prevent claim denials and ensure appropriate reimbursement.
The CPT code 76120 is not typically reimbursed by Medicare. According to the Medicare Physician Fee Schedule (MPFS), certain services, including those represented by CPT code 76120, may not be covered due to various reasons such as lack of medical necessity or being considered experimental.
Additionally, Medicare Administrative Contractors (MACs) play a crucial role in determining the coverage and reimbursement policies for specific CPT codes within their jurisdictions. It is essential for healthcare providers to consult their local MAC guidelines to verify the reimbursement status of CPT code 76120, as there may be variations based on regional policies and specific circumstances.
Discover the power of MD Clarity's RevFind software to ensure you're receiving every dollar you're owed. With the ability to read your contracts and detect underpayments down to the CPT code level, including CPT code 76120, RevFind provides unparalleled accuracy and insight by individual payer. Schedule a demo today to see how RevFind can optimize your revenue cycle and enhance your financial performance.
Get paid in full by bringing clarity to your revenue cycle
Subscribe to the
Healthcare Clarified newsletter
Get the latest insights on RCM and healthcare policy in your inbox
