Radiology Coding Alert

Question: I’m the newest coder in our radiology office and I’m confused about how I should code the following: I have a report of a patient who was seen by two separate providers for five separate chest X-rays throughout the same day. How should I code this service?

AAPC Forum Participant

Answer: Yes, we can take a look at that scenario as it can easily become confusing. So, let’s take your example and break it down:

• The first X-ray is taken at 9:00 a.m. by Dr. Smith
• Next, the same chest X-ray is repeated at 12:00 p.m. by Dr. Smith
• At 3:00 p.m., that chest X-ray is repeated again by Dr. Smith
• At 7:00 p.m., Dr. Yang takes the same chest X-ray, but he is under a different national provider identifier (NPI) than Dr. Smith
• At 11:00 p.m., Dr. Yang takes a fifth and final X-ray

Let’s say the chest X-ray is coded as 71045 (Radiologic examination, chest; single view).

You will need to use modifiers 76 (Repeat procedure or service by same physician or other qualified health care professional) and 77 (Repeat procedure by another physician or other qualified health care professional) on the claim to avoid a denial.

Here is how your claim should look:

Line 1: 71045 billed with 1 unit of service by NPI 1

Line 2: 71045 with modifier 76 with 2 units of service by NPI 1

Line 3: 71045 with modifier 77 with 2 units of service by NPI 2.

Lindsey Bush, BA, MA, CPC, Production Editor, AAPC