Title: Imaging, Nuclear Medicine and Radiation Oncology
Course: Intermediate Coding and Classification Systems > Section: Module 14: Imaging, Nuclear Medicine and Radiation Oncology

Introduction

You are doing great! The last two chapters you will cover are Chapters 24 and 25. This is in the Ancillary Section which includes Imaging, Nuclear Medicine and Radiation Oncology. Chapter 25 consists of Physical Rehabilitation, Audiology, Mental health, and Substance Abuse Treatment.

The first character for the Imaging section is B. The imaging section splits the musculoskeletal system into the axil and non-axial skeleton and provides a body system for fetus and obstetrical imaging. There are 5 root types for imaging:

- Plain radiography
- Fluoroscopy
- Computerized Tomography (CT)
- Magnetic Resonance Imaging (MRI)
- Ultrasonography

Imaging guidance done to assist in the performance of a procedure is coded separately in this section as the root type Fluoroscopy or Ultrasound, with the qualifier A, Guidance. In addition contrast. It is best to read the medical reports to determine whether high or low osmolar contrast materials are used.

The Nuclear Medicine Section you will learn about radioactive elements that have been irradiated with neutrons and become radionuclides that will create recordable images. The body systems are similar to the Medical and Surgical sections and the root types describe the therapeutic form and diagnostic testing done with the use of Nuclear Medicine technology. There are many radionuclides used in nuclear Medicine and Table 24.8 lists the values for coding nuclear medicine procedures.

The Radiation Oncology Section is used to code the use of various doses of radiation on a particular schedule to treat and kill tumor cells while trying to spare the normal tissue. Various modes of treatment are used, based on the type of tumor and the location within the body. The treatment sites mirror the body parts in the Medical and Surgical section. Root operations include:

- Beam Radiation
- Brachytherapy
- Stereotactic radiosurgery
- Other radiation

Isotope values are provided to indicate the type of isotope used in the treatment protocol for radiation oncology.

In the last chapter for the course, you will learn about physical rehabilitation, audiology, mental health, and substance abuse treatments and may not be coded in all facilities. Physical rehabilitation and Diagnostic Audiology are not body systems so the 2nd character has been labeled “Section Qualifier” instead of “Body System.”

The Mental Health Section provides 12 root types to describe mental health services. Read through the root types and their definitions focusing on what it is used for. There are qualifier values for Psychological Testing, Psychotherapy, and Counseling.

Substance Abuse treatment section includes 7 root types. These 7 root types include:

- Detoxification services
- Individual counseling
- Individual psychotherapy
- Family counseling
- Medication management
- Pharmacotherapy

The 5th through 7th characters in the mental health and substance abuse treatment code is not currently defined and is reported as the qualifier of Z, None.

Course Outcomes

- Describes the basic coding steps for coding medical procedures in both ICD-9-CM and ICD-10-PCS. (1)
- Interprets the basic coding guidelines established by the American Hospital Association for both ICD-9-CM and ICD-10-PCS. (2)
- Converts medical documentation into both ICD-9-CM and ICD-10-PCS codes. (3)
- Applies the official coding guidelines to the coding of medical procedures for all body systems (circulatory, respiratory, musculoskeletal, urinary, blood organs, reproductive, gastrointestinal, etc.) (4)
- Resolves discrepancies in medical documentation and accurate code assignment through the physician query process. (5)
- Analyzes medical documentation to assign accurate codes for reimbursement of health care services. (6)
- Evaluates and assigns accurate medical procedure codes through analysis of case studies. (7)
- Compares and contrasts the differences between the ICD-9-CM and ICD-10-PCS classification systems. (8)

Objectives

Upon completion of this module you should be able to:

- Describe the character definitions for each of the sections, including those that differ from the Medical and Surgical section.
- List and describe the root types for the Imaging section.
- Describe the types of contrast values available in the Imaging section.
- Discuss the two qualifier values in the Imaging section.
- Distinguish between diagnostic and therapeutic Nuclear Medicine.
- Discuss the root types in the Nuclear Medicine section.
- Identify the action of the radionuclides in Nuclear Medicine procedures.
- List the four modalities in the Radiation Oncology section and describe the modality qualifiers.
- Describe the use of the Intraoperative qualifier in Radiation Oncology.
- List types of procedures coded in the Physical Rehabilitation and Diagnostic Audiology, Mental Health and Substance Abuse Treatment sections.
- Describe the character definitions for each of the sections, including those that differ from the Medical and Surgical section.
- List and describe the root types for the Physical Rehabilitation and Diagnostic Audiology section.
- Distinguish between device fitting, coded in the Physical Rehabilitation section, and device placement, coded in the Placement section
- Describe the subdivisions of body system/region in the Physical Rehabilitation section.
- Discuss the type qualifiers and equipment common to the Physical Rehabilitation and Diagnostic Audiology section.
- List and describe the root types for the Mental Health section.
- Describe type qualifiers used in the Mental Health section
- List and describe the root types for the Substance Abuse Treatment section.
- Describe type qualifiers used in the Substance Abuse Treatment section.
- Identify the last three character values for all Mental Health and Substance Abuse Treatment codes.

Readings & Resources

- Chapters 24 and 25
- Complete all exercises and check your answers
- Review Coding Guidelines on root operations
- Read Coding Tips