Cora Posted Wed 09th of May, 2012 17:16:34 PM
We are trying to get a bilateral xray of the hip paid. This xray was NOT with a view of the pelvis. Would `73510' code be use with a 59 modifer?
SuperCoder Answered Wed 09th of May, 2012 17:29:16 PM
Language in code descriptions for radiological examinations of the hips sometimes confuses coders.
CPT provides two clear-cut codes for unilateral studies, says Michelle Juette, CPC, RCC, business services manager for Yakima Valley Radiology in Yakima, Wash.: 73500 (radiologic examination, hip, unilateral; one view) and 73510 (... complete, minimum of two views). Likewise, coding a bilateral study involving only one view of each hip is equally uncomplicated. "The coder would report 73500 twice with the bilateral modifier -- either modifier -50 (bilateral procedure) or the -RT/-LT indicator, depending on payer guidelines," Juette says.
Less straightforward, however, is the code for another bilateral exam, 73520 (radiologic examination, hips, bilateral, minimum of two views of each hip, including anteroposterior view of pelvis). "The reference to an AP view of the pelvis raises the question of how to code bilateral x-rays with multiple views," she points out. In many instances, coders assume that the original physician's order or the radiology report must indicate that a separate AP pelvis was obtained and documented, in addition to two or more views of both hips.
But this isn't the case. When x-raying hips, technicians routinely obtain an AP view of the pelvis along with views of the hip (i.e., lateral, side). The language in 73520 reflects this common practice, but performing a discrete AP pelvis when bilateral views of the hips are obtained is not required. Therefore, 73520 is appropriately reported for any bilateral hip study with two or more views.
Source:Radiology Coding Alert