Radiology Changes in CPT® 2018

Radiology Changes in CPT® 2018

The most significant changes to the radiology portion of CPT® 2018 are related to chest and abdominal imaging services.
Codes for chest X-rays are simplified: Nine codes are deleted and replaced by four new codes, which are based solely on the number of views.

71010 Radiologic examination, chest; single view, frontal
71015 … stereo, frontal
71020 Radiologic examination, chest, 2 views, frontal and lateral;
71021 …with apical lordotic procedure
71022 … with oblique projections
71023 … with fluoroscopy
71030 Radiologic examination, chest, complete, minimum of 4 views;
71034 … with fluoroscopy
71035 Radiologic examination, chest, special views (eg, lateral decubitus, Bucky studies)


71045 Radiologic examination, chest; single view
71046 … 2 views
71047 … 3 views
71048 … 4 or more views

The deleted codes (71010-71035) previously were identified as potentially misvalued. The American College of Radiology (ACR) requested an update to increase the flexibility and accuracy when coding customized exams.
Codes describing radiologic examination of the stomach are similarly revised (for similar reasons), to be reported based on the number of views.

74000 Radiologic examination, abdomen; single anteroposterior view
74010 … anteroposterior and additional oblique and cone views
74020 … complete, including decubitus and/or erect views


74018 Radiologic examination, abdomen; 1 view
74019 … 2 views
74021 … 3 or more views

John Verhovshek
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About Has 584 Posts

John Verhovshek, MA, CPC, is a contributing editor at AAPC. He has been covering medical coding and billing, healthcare policy, and the business of medicine since 1999. He is an alumnus of York College of Pennsylvania and Clemson University.

19 Responses to “Radiology Changes in CPT® 2018”

  1. R. Suganthi says:

    Hi, Good information about X-rays, is there any changes in MRI, CT, NM.

  2. Janeris R says:

    One of my doctors asked the question- An obese person may need additional images than a slender person. Does the amount of images taken equal views?

  3. Kim says:

    We are experiencing denials from BCBS TX for the TC component of the new chest xray codes stating the modifier is invalid. Is anyone else experiencing this kind of denial? All other payers are processing as usual.

  4. Mary says:

    Is there a change in these new codes, specifically 71046, that no longer allows a Nurse Practitioner to bill for the chest x-ray? Nurse practitioners were allowed to bill for the old code 71020.

  5. Amy says:

    What modifier would you use when billing 71046 and 71045 together? -59 or -XU?

  6. Chris steiner says:

    We too are receiving denials from blue shield for invalid modifier (we bill with 26 modifier) we were told we had to contact ama for clarification (we did and were told no, we need to contact AAPC) so we did, no help there either. So we appealed with blue shield providing the coding guidelines for new chest and ab xrays, and guess what?!? Still denied they stand behind them stating invalid use of modifier…..really?!?!

  7. Keri says:

    Mary, did you ever get an answer about Nurse Practitioner billing for 71046? I am having the same issue.

  8. Kingston says:

    FL Medicaid and MCOs denying the New codes 71045, 71046. If any one have update on this please share.

  9. Debbie says:

    We are also having BCBS deny claims with the TC modifier, has anyone found out what they are wanting or what has changed.

  10. claudia Ramirez says:

    All NJ Insurances have been rejecting the new code for chest xray 71046, can you please let me know if i need a modifier!.

  11. Eswaran Pandiyaraj says:

    Can any one provide solution of CPT 71046 denied as inconsistent modifier denial for BCBS Texas when performed nurse practitioner?

  12. EA says:

    My providers lost the first three weeks of revenue in January 2018 for BCBS chest x-rays and abdomen x-rays. These are among most frequently billed codes in radiology and a large portion of our business. We re-filed after BCBS fixed their processing problems, all rejected as duplicates. We’ve asked TMA for help, no assistance. BCBS said “file corrected claims on paper” or “submit a project but we don’t have a format.” This is holding up accounts with other charges. What is everyone else doing, writing these off? Same song, different year, different payor.

  13. Jodie says:

    Medicaid is denying 71045 & 74018 for portable radiology, stating only payable for provider type 29, 30, 34. We always got paid before the codes changed in 2018, and calling Medicaid & ACHA are no help. Any advise?

  14. kelli says:

    We are a radiology group seeing denials for cpt 74018 and 71045 from Blue Cross and United Medicare Mgd Care, for unbundling, all of us here were under the understanding that the bundle code of 74022 was a complete abd with pa chest, anyone else having this problem?

  15. Christine Oliver says:

    When billing two views of the chest and ribs-rt and lt would the appropriate code be the 71111?

  16. Lorena Powers says:

    Medicare denying the New code 71046. If any one have update on this please share.

  17. Jennifer Davis says:

    There does not appear to be a direct crosswalk for CPT code 71021 – Chest x-ray frontal and lateral; with apical lordotic procedure. This was previously a much higher reimbursement that the new 71046 – Radiologic examination, chest; 2 views, which does not seem to account for the procedure component. Is the appropriate replacement code for 71021 supposed to be 71046, or is there a different code this was crosswalked to?

  18. Teri Blackman says:

    What is Medicare Rate for 71045 X-ray Chest Exam 1 view

  19. Senthil says:

    Hi I’m Having the Issues for the CPT codes 71045 and 74018 bundled together denial…in same day…is there any conclusion? need to add any modifier/combo code?