Orthopedic Coding Alert

Question: We performed x-rays in the office for a patient with a wrist injury. We did the standard anteroposterior/lateral and scaphoid views, as well as ulnar deviated, ulnar oblique, radial deviated and radial oblique views. We also did stress views of the wrist. I reported 73110 and 76006. Am I missing something?

Colorado Subscriber

Answer: You're correct to report 73110 (Radiologic examination, wrist; complete, minimum of three views). But you may run into a problem with 76006 for the stress views. CPT 2007 deleted 76006 and replaced it with 77071 (Manual application of stress performed by physician for joint radiography, including contralateral joint if indicated). Code 77071's descriptor is identical to that previously used for 76006. CPT Changes 2007: An Insider's View indicates that CPT made the code change "to allow for more appropriate placement in the new subsection for Bone/Joint Studies."

And although you provided more than three wrist views during your x-ray examination, 73110's descriptor specifically indicates that it represents a "minimum" of three views. And your additional views reflect the "complete" wrist examination.

So there are no extra codes you can report for the deviated and oblique x-rays because 73110 reflects all the work involved.

-- Reader Questions and You Be the Coder were reviewed by Heidi Stout, CPC, CCS-P, director of orthopedic coding services at The Coding Network LLC; and Bill Mallon, MD, orthopedic surgeon and medical director at Triangle Orthopaedic Associates in Durham, N.C.