Health Information Management

Q&A: Why are multiple port film line items denied?

APCs Insider, February 8, 2013

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Q: We received a line item denial for our port films. The documentation in the record supported the films we billed, but the line item was not reimbursed. We have run out of theories as to why. Do you have any thoughts about why this happened?

A: Multiple port films may be ordered and performed, but you may only report a unit of one.
 
The definition for CPT® code 77417 states: Therapeutic radiology port film(s).
 
 Since the wording is film(s), this includes one or several films performed. According to CMS’ National Correct Coding Initiative (NCCI) manual (chapter 9) updated January 1, 2013, theMUE value for this code is one since it includes all port films.  
 
If providers frequently perform more than one film, review the cost/charge reported for this code and reflected in the line item when reported. Typically, this is a chargemaster (CDM) driven code so facilties may be able to indicate the number of port films performed in the CDM description. That would allow the facility to adjust the cost/charge accordingly, depending on its charge methodology.
 
Editor’s note: Denise Williams, RN, CPC-H, vice president of revenue integrity services at Health Revenue Assurance Associates, Inc., in Plantation, Fla., answered this question.



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