Puff Up Your Chest to Confidently Code X-Ray Procedures
Can you report 71101 and 71111 with an AP view? The upper body is home to several different types of structures that are vital to a patient’s health. When a patient has injuries or other issues arise around the chest, radiologists will capture X-rays to visualize the structures and evaluate the patient’s condition. Read on to learn how to select the correct X-ray codes for the chest and nearby structures. Confirm Chest X-Ray Code Knowledge Radiologists capture chest X-rays to visualize the structures within the chest to evaluate for several conditions. These conditions include pneumonia, pulmonary fibrosis, and fractures. Codes featured in the CPT® code book differ in the number of views captured: When you’re reviewing the radiology report, count the number of different views the radiologist used to image the patient’s chest. Common views to look for include anteroposterior (AP), posteroanterior (PA), and lateral. Radiologists may capture other views, too, such as decubitus, lordotic, and expiratory. Important: Remember to pay attention to guidelines and parenthetical notes in the CPT® code book to ensure you’re using the correct codes for the documented procedures. For example, if the radiologist captured a complete acute abdomen radiologic series with a minimum of two abdominal views and one chest X-ray view, you’ll assign 74022 (Radiologic examination, complete acute abdomen series, including 2 or more views of the abdomen (eg, supine, erect, decubitus), and a single view chest) rather than two separate codes. Report Rib and Chest X-Rays If a patient presented with an upper body injury that required imaging of the chest and ribs, you’ll refer to the 71100-71111 code range when reporting the X-rays: When the radiologist captures X-rays of the patient’s ribs, you’ll use 71100 to report X-rays on one side of the body (unilateral) or assign 71110 for X-rays of both sides of the body (bilateral). For 71100, a radiologist will typically capture AP, or front to back, images and PA, or back to front, images of the patient’s ribs on the same side of the body. Three views are required to report 71110, and those views tend to be AP, PA, and lateral. If the radiologist captures images of the ribs and the patient’s chest, you’ll refer to either 71101 or 71111 depending on if the X-rays were captured unilaterally or bilaterally. Code 71101 also requires a minimum of three views, while the radiologist must capture at least four views for you to assign 71111. You’ll also notice that each code features “including posteroanterior chest” in the descriptor. Does this mean the chest view must be a PA image? Not necessarily. According to CPT® Assistant, Vol. 31, Issue 12, you may report 71111 “when either a PA or AP view of the chest is performed with three or more views of bilateral ribs.” The article continues to state you may apply the same reasoning to 71101 when reporting unilateral rib X-rays and a chest X-ray. Solidify Your Sternum Imaging Understanding The sternum, also known as the breastbone, is a flat, vertical bone at the center of the chest that helps shield the patient’s muscles and organs. The sternum helps form a portion of the ribcage by connecting to other bones and muscles. Patients may experience sternum pain or pain behind the breastbone (substernal pain) that could be indicative of other conditions, such as: Radiologists commonly capture AP and PA views of the sternum to evaluate the body structure. Use 71120 (Radiologic examination; sternum, minimum of 2 views) when the provider’s documentation specifies X-rays of the patient’s sternum. The sternum connects to the clavicles (collarbones) via the sternoclavicular joints. Patients who have experienced traumatic injury, infection, deformity, or congenital abnormalities can undergo X-rays of the sternoclavicular joints so the physician can evaluate their condition. You’ll assign 71130 (… sternoclavicular joint or joints, minimum of 3 views) to report the procedure. The documentation and stored images need to include at least three different views, which may include PA, lateral, and oblique projections. Mike Shaughnessy, BA, CPC, Development Editor, AAPC
