Radiology Coding Alert

Question: Which modifiers would I assign if a patient has two chest x-rays on the same day but each is read by a different radiologist?

Florida Subscriber  
Answer: The first x-ray should be reported with the appropriate CPT code (e.g., 71010, radiologic examination, chest; single view, frontal). Modifier -77 (repeat procedure by another physician) should be appended when the service is reported the second time (71010-77). This might occur when an infant has respiratory distress syndrome (769) and the physician is monitoring how well the childs lungs are functioning.
 
If the same physician interpreted films obtained at two different times during the same day, modifier -76 (repeat procedure by same physician) should be appended instead.
 
On occasion, the two procedures might require a different modifier. For instance, the first x-ray might be a two-view chest (71020, frontal and lateral) and the subsequent film a one-view chest (71010). Code 71010 is bundled into 71020, so payers would probably disallow 71010. However, when modifier -59 (distinct procedural service) is appended, the payer is alerted that the two x-rays were obtained during separate sessions. The radiology report should document the time of each imaging service to substantiate the use of modifier -59.