Advanced Search

Orthopedic Coding Alert

READER QUESTIONS :

For Comparison X-Ray, Use This Diagnosis

Published on Sat Jul 04, 2009

Question: A patient comes in with shoulder pain and possible separation. The orthopedist takes an x-ray of the patients other shoulder to compare the two. What diagnosis code should I use for the good shoulder? Alabama Subscriber Answer: For the good shoulder that the orthopedist used for comparison, you should use V72.5 (Radiological examination, not elsewhere classified) when the patient has no signs, symptoms or associated diagnoses. Watch out: If you use this code on the claim, however, Medicare will treat it as a noncovered, nonmedically necessary service that the patient is financially responsible for. This can result in an unhappy patient who may take his complaints back to his treating physician. For the other shoulder, you should use 719.41 (Pain in joint; shoulder region).
You’ve reached your limit of free articles. Already a subscriber? Log in.
Not a subscriber? Subscribe today to continue reading this article. Plus, you’ll get:
  • Simple explanations of current healthcare regulations and payer programs
  • Real-world reporting scenarios solved by our expert coders
  • Industry news, such as MAC and RAC activities, the OIG Work Plan, and CERT reports
  • Instant access to every article ever published in your eNewsletter
  • 6 annual AAPC-approved CEUs*
  • The latest updates for CPT®, ICD-10-CM, HCPCS Level II, NCCI edits, modifiers, compliance, technology, practice management, and more
*CEUs available with select eNewsletters.

Other Articles in this issue of

Orthopedic Coding Alert

View All