Orthopedic Coding Alert

Question: Notes indicate that the orthopedist performed an elbow X-ray examination along with a two-view forearm X-ray. I’m not sure about the elbow X-ray code, because I see that some elbow X-ray codes include arthrography. What is arthrography, and how should I code this encounter?

Kansas Subscriber

Answer: Coding is easy enough for the forearm X-ray. On the claim, report 73090 (Radiologic examination; forearm, 2 views).

As for the elbow X-ray, things are a little trickier. You’ll choose from one of the following X-ray codes, depending on encounter specifics:

• 73070 — Radiologic examination, elbow; 2 views
• 73080 — … complete, minimum of 3 views
• 73085 — Radiologic examination, elbow, arthrography, radiological supervision and interpretation.

Definition: According to Johns Hopkins Medicine, arthrography is a “type of imaging test used to look at a joint, such as the shoulder, knee, or hip. It may be done if standard X-rays do not show the needed details of the joint structure and function.”

During an arthrography, “a long, thin needle is used to put contrast dye right into the joint and a series of X-rays is taken with the joint in various positions. X-rays use small amounts of radiation to get pictures of the inside of the body. Sometimes air is used as the contrast substance when regular contrast cannot be used.”