Orthopedic Coding Alert

 You'll hit your claims on the mark every time with these expert tips If you can't get a handle on coding x-ray services, you're not alone. But as long as you document the x-ray type and quantity, you'll be on your way to x-ray expertise.
 
According to CMS data, x-ray codes make up nearly half of orthopedists' 20 most frequently performed procedures, but x-rays can still confound even the most seasoned orthopedic coder. Secure reimbursement for these procedures with the following expert answers to your most pressing x-ray questions. Standing Knee View Won't Always Warrant 73565 Question 1: Your practice performs a two-view left knee x-ray while the patient lies flat, and another left knee x-ray while the patient stands up. Can you report both 73560 and 73565? Answer: No. Because 73565 (Radiologic examination, knee; both knees, standing, anteroposterior) describes "both knees," you cannot report this code with 73560 (Radiologic examination, knee; one or two views) if you only examine one knee.
 
Instead, you should add up the total number of views that you took, says Anne Crandall, LPN, office manager at Spine and Sports PC in Memphis, Tenn. Therefore, if you perform two views of the left knee while the patient lies in the supine position and one standing view of the left knee, you should report 73562 (Radiologic examination, knee; three views).
 
You should report 73565 only if you perform anteroposterior (AP) upright views of both knees. Document X-Ray View Types, Not Just Quantity Question 2: The orthopedist requests a complete cervical spine x-ray series. Your office's x-ray technologist shoots and documents five spine views, so the coder reports 72052. Is this the correct code? Answer: Determining the correct code is impossible, says Cheryl A. Schad, BA, CPCM, CPC, owner of Schad Medical Management, a medical reimbursement consulting firm in New Jersey. Your x-ray tech may have shot five views, but because the tech didn't document the types of views, you can't tell whether she performed a complete series or whether she simply shot five anteroposterior AP views. You probably assume that the tech would never perform five AP views, but you'll find it impossible to prove otherwise without the appropriate documentation.
 
Although x-ray technologists should always document the number and types of radiologic views they take, the types of views - not just the number - will help you determine your code.
 
If your practitioner dictates only five cervical spine views, the highest code you can assign is 72050 (Radiologic examination, spine, cervical; minimum of four views). To report a complete series (72052, Radiologic examination, spine, cervical; complete, including oblique and flexion and/or extension studies), you must shoot bilateral oblique views, a flexion-extension lateral view, and articular pillar (facet) views. [...]