Radiology Coding Alert

Question: How should we code the different components when a physician orders bilateral wrist x-rays, two views, and bilateral hand x-rays, two views? The office tech took only two films because she got both right and left extremities and both joints (wrist and hands) on the film plate she uses.


Colorado Subscriber


Answer: For most payers, report 73100 (Radiologic examination, wrist; two views) twice and 73120 (Radiologic examination, hand; two views) twice, appending the appropriate modifiers.

Why: CPT defines x-rays in terms of views, not films.

What to do: Determine if you're coding for the global service, the professional component (26, Professional component), or the technical component (TC, Technical component).

Next: Report the multiple services based on your payer's preference. Examples: Your payer may ask you to report any of the following:

• Two units of 73100
• 73100-50 (Bilateral procedure)
• 73100-LT (Left side), 73100-RT (Right side)
• 73100, 73100-59 (Distinct procedural service)
• 73100, 73100-76 (Repeat procedure by same physician).

Note: For larger-than-average patients, you may need to use several films to document a single view of a particular part of the patient's anatomy. When this happens, you still charge for one exam, even though your costs are greater than if you had needed only one film.

On the other hand, you sometimes fit two different structures onto a single film, as in your question. For coding purposes, however, these are two separate exams and you should code them separately unless the payer requires otherwise. This applies to the technical component as well as the professional component.