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knee xray

Eunice Posted Tue 04th of June, 2013 15:04:48 PM

Suppose a referring physician orders knee X-Rays, but he wants specific views performed. He requests “right lateral, standing PA bilateral knees @45 degree flexion, AP weight bearing bilateral one film and skyline patella bilateral views of the knee X-Ray” with a diagnosis of status post right total knee replacement.

Can we bill bilateral knees (73564-RT and 73562-LT)?

SuperCoder Answered Thu 06th of June, 2013 06:34:50 AM

From a coding perspective, the codes are correct. However, because the diagnosis is specific to the right knee, it suggests the left knee views are for comparison. You’ll need to check payer policy for comparison view reimbursement. Many won’t consider comparison views medically necessary or will consider them medically necessary in limited circumstances.

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