BethL_66685
New member
If a provider requests a 3 view knee as well as a long leg film to take leg measurements, how is this coded? Are you able to code the additional film that is inclusive of the entire lower extremity?
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Resolved Radiology Question
- Thread starter BethL_66685
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Lori
Well-known member
Report Only the Number of Views Documented
The number of views claimed must meet the basic requirements of the CPT® code reported. If your department or office has a list of “standard views,” or the number of views to be imaged on a patient, you cannot use it for coding purposes. The medical report must state the number of views. It is the coder’s responsibility to count the number of views and select the correct corresponding CPT® code.
For example, a knee exam may be reported using one of four CPT® codes. To report 73564 Radiologic examination, knee; 4 or more views, documentation has to substantiate four or more views. If the physician does not state “four views,” but rather documents “AP, lateral, and both obliques,” that is also acceptable documentation. If, however, the physician uses the phrase multiple views of the knee, the rules state you must report the lowest-level corresponding CPT® code for the particular study (73560 Radiologic examination, knee; 1 or 2 views).
This holds true for referring physician orders, too. If the views or the number of views are not listed in the order, the radiology office cannot impose their department standards of, for instance, four views. Instead, the radiology department or office should contact the referring physician and ask for a new order indicating the views he would like performed.
Note, however, that some diagnostic studies require specific view names. For example, if the physician dictates the number of abdomen views instead of the precise names of the views, you must report the lowest-level code (74000 Radiologic examination, abdomen; single anteroposterior view) for that service.
www.aapc.com
1. Radiology Codes When a provider takes an x-ray in his/her facility, interprets the study and writes a report, the appropriate radiology code is reported.
2. Professional Component -26 Modifier Imaging procedures may be comprised of both a technical component and a professional component. The professional component only is indicated with a -26 modifier and is used only for the initial interpretation of films. Preparation of a separate written report is mandatory.
3. E/M consultation Services When a patient presents to a provider for a new or established patient visit or for a consultation visit and brings his/her medical records, including x-rays or other imaging studies, the proper E/M or consultation service is reported. Imaging studies that have been read and include an initial report are considered medical records; therefore review of these studies is considered a portion of the E/M service. E/M codes include work done before, during or after the E/M visit. Please note, however, that the amount and/or complexity of medical records, diagnostic tests, and/or other information that must be obtained, reviewed and analyzed is included as one of the elements of medical decision making when choosing the appropriate E/M service to report.
X-Ray CPT Code’s guidelines:
X-rays codes are arranged like a minimal view to maximum views(stand-alone code followed by one or more intended codes).
Eg: For X-Ray Wrist, we have two codes in the CPT book under Radiology Section
CPT 73100 – Radiological examination of the wrist; 2 views
CPT 73110 – Radiological examination of the wrist; minimum of 3 views
A. If a single view of wrist x-ray is performed then append modifier 52 (Reduced service) with CPT 73100 (Because of CPT code description states it's 2 views).
B. If four or more views of wrist x- rays are taken no need to append any modifier with CPT 73110 since the CPT description is stating that it’s minimum of 3 views.
C. If bilateral wrist x- rays are taken then we can code either using modifier 50 (Bilateral procedures modifier) or modifier RT & LT.
Eg: 73100 – 50
(Or)
73100 – RT
73100 – LT
www.codingprime.in
You’ll also need to know about contrast materials. Contrast materials are substances used to enhance the contrast of images taken with x-rays, MRIs, and ultrasounds. These materials, like barium or iodine, help make certain elements of the body show up more starkly in the radiological exam. Some contrast materials may be injected, while others are swallowed or delivered by enema.
This can become complicated, because many procedure codes in Radiology mention procedures with or without contrast. In cases where a patient drinks or receives the contrast medium via enema, do not code with contrast. If the contrast medium is injected into the patient, you should code with contrast.
www.cco.us
The number of views claimed must meet the basic requirements of the CPT® code reported. If your department or office has a list of “standard views,” or the number of views to be imaged on a patient, you cannot use it for coding purposes. The medical report must state the number of views. It is the coder’s responsibility to count the number of views and select the correct corresponding CPT® code.
For example, a knee exam may be reported using one of four CPT® codes. To report 73564 Radiologic examination, knee; 4 or more views, documentation has to substantiate four or more views. If the physician does not state “four views,” but rather documents “AP, lateral, and both obliques,” that is also acceptable documentation. If, however, the physician uses the phrase multiple views of the knee, the rules state you must report the lowest-level corresponding CPT® code for the particular study (73560 Radiologic examination, knee; 1 or 2 views).
This holds true for referring physician orders, too. If the views or the number of views are not listed in the order, the radiology office cannot impose their department standards of, for instance, four views. Instead, the radiology department or office should contact the referring physician and ask for a new order indicating the views he would like performed.
Note, however, that some diagnostic studies require specific view names. For example, if the physician dictates the number of abdomen views instead of the precise names of the views, you must report the lowest-level code (74000 Radiologic examination, abdomen; single anteroposterior view) for that service.
Seven Tips for Diagnostic Radiology Coding Success
Follow AMA, CMS, ACR, individual payer rules, and these helpful tips for surefire billing. By Terry Leone, CPC, CPC-P, CPC-I, CIRCC, and G. J. Verhovshek,
1. Radiology Codes When a provider takes an x-ray in his/her facility, interprets the study and writes a report, the appropriate radiology code is reported.
2. Professional Component -26 Modifier Imaging procedures may be comprised of both a technical component and a professional component. The professional component only is indicated with a -26 modifier and is used only for the initial interpretation of films. Preparation of a separate written report is mandatory.
3. E/M consultation Services When a patient presents to a provider for a new or established patient visit or for a consultation visit and brings his/her medical records, including x-rays or other imaging studies, the proper E/M or consultation service is reported. Imaging studies that have been read and include an initial report are considered medical records; therefore review of these studies is considered a portion of the E/M service. E/M codes include work done before, during or after the E/M visit. Please note, however, that the amount and/or complexity of medical records, diagnostic tests, and/or other information that must be obtained, reviewed and analyzed is included as one of the elements of medical decision making when choosing the appropriate E/M service to report.
X-Ray CPT Code’s guidelines:
X-rays codes are arranged like a minimal view to maximum views(stand-alone code followed by one or more intended codes).
Eg: For X-Ray Wrist, we have two codes in the CPT book under Radiology Section
CPT 73100 – Radiological examination of the wrist; 2 views
CPT 73110 – Radiological examination of the wrist; minimum of 3 views
A. If a single view of wrist x-ray is performed then append modifier 52 (Reduced service) with CPT 73100 (Because of CPT code description states it's 2 views).
B. If four or more views of wrist x- rays are taken no need to append any modifier with CPT 73110 since the CPT description is stating that it’s minimum of 3 views.
C. If bilateral wrist x- rays are taken then we can code either using modifier 50 (Bilateral procedures modifier) or modifier RT & LT.
Eg: 73100 – 50
(Or)
73100 – RT
73100 – LT
Radiology coding guidelines
Medical Coding, Anatomy , ICD, CPT, CPC, Coding Info , Medical Coders , physicians, medical students , help to clear CPC Exam...
You’ll also need to know about contrast materials. Contrast materials are substances used to enhance the contrast of images taken with x-rays, MRIs, and ultrasounds. These materials, like barium or iodine, help make certain elements of the body show up more starkly in the radiological exam. Some contrast materials may be injected, while others are swallowed or delivered by enema.
This can become complicated, because many procedure codes in Radiology mention procedures with or without contrast. In cases where a patient drinks or receives the contrast medium via enema, do not code with contrast. If the contrast medium is injected into the patient, you should code with contrast.
Administration of Contrast Job Aid Tool & Cheatsheet
Free Job Aid: This Administration of Contrast Job Aid Tool & Cheatsheet will help you code Administration of Contrast in Radiology.
www.cco.us
BethL_66685
New member
The question at hand is really the long leg view. Is it coded as just an additional view or can it be coded as an orthoroentogenogram?
Lori
Well-known member
Orthoroentgenogram is a radiographic study used to evaluate anatomic leg length and calculate leg-length discrepancies. This study utilizes a long ruler placed on the film, and three radiographs including bilateral hips, knees and ankles.
Similar studies used to evaluate true leg length include:
77073, Bone length studies (orthoroentgenogram,scanogram)
When it is appropriate to bill 77073—bone length studies (orthoroentgenogram, scanogram)—with the following codes?
Answer:
It would be rare that both 77073 and 73562/73564 would be reported together.
You would need separate orders and medical necessity for the knee views separate from the bone length exam. Any knee images taken as part of the scanogram would be included in 77073.
Similar studies used to evaluate true leg length include:
- teleoroentgenogram: performed as a single-exposure weight-bearing study
- scanogram: low-radiation technique similar to an orthoroentgenogram utilizing three exposures
- computed tomography (CT): (computed tomography scanogram for leg length discrepancy assessment): possibly the most accurate technique, removing possible measurement error from limbs not being parallel to a ruler or in the plane of the imaging
77073, Bone length studies (orthoroentgenogram,scanogram)
When it is appropriate to bill 77073—bone length studies (orthoroentgenogram, scanogram)—with the following codes?
| 73562 | Radiologic examination, knee; 3 views |
| 73564 | Radiologic examination, knee; complete, 4 or more views |
It would be rare that both 77073 and 73562/73564 would be reported together.
You would need separate orders and medical necessity for the knee views separate from the bone length exam. Any knee images taken as part of the scanogram would be included in 77073.
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