Radiology Coding Alert

Question: Our practice performs a lot of x-rays, including patients with broken fingers and toes. Can you tell me how to use modifiers FA-F9 and TA-T9 appropriately when we take these x-rays?

California Subscriber

Answer: The modifiers you refer to are location modifiers that indicate which finger, thumb or toe is being x-rayed, and on which hand or foot. For instance, modifier FA indicates left hand, thumb, while F7 is right hand, third digit. T5 is right foot, great toe, and T4 is left foot, fifth digit. However, these level II HCPCS modifiers are not used by Medicare for physician office billing, but are required for hospitals and ambulatory surgical centers only.

Further, these modifiers are unnecessary because the CPT code descriptions for finger and toe x-rays include multiple digits. For example, code 73140 states radiologic examination, finger(s), minimum of two views, and 73660 states radiologic examination; toe(s), minimum of two views. In other words, the code is the same if one or multiple digits on the same extremity are imaged. If x-rays are taken of digits on both hands or feet, however, you append modifier -50 (bilateral procedure) to indicate a bilateral procedure.