Eunice Posted Mon 17th of June, 2013 13:57:26 PM
Patient had PA and lateral views of the chest xray, there was questionable area at the right lung so patient came back and had PA and shallow oblique views with nipple markers on the same date.
What is correct CPT to bill?
SuperCoder Answered Tue 18th of June, 2013 14:37:02 PM
If the payer allows only the highest or total number of views to be reported for a single date, 71022 - Radiologic examination, chest, 2 views, frontal and lateral with oblique projections – seems to be the best option. Note this quote from the CCI manual, Chapter IX, Section C.1: “If radiographs have to be repeated in the course of a radiographic encounter due to substandard quality, only one unit of service for the code can be reported. If the radiologist elects to obtain additional views after reviewing initial films in order to render an interpretation, the Medicare policy on the ordering of diagnostic tests must be followed. The CPT code describing the total service should be reported, even if the patient was released from the radiology suite and had to return for additional services.”
As individual encounters, the codes appear to be (1) 71020, Radiologic examination, chest, 2 views, frontal and lateral and (2) 71022-52 (PA and shallow oblique with no lateral) with mod 59.