Radiology Coding Alert
Reread Descriptors to Locate the Correct X-ray Code
Question: A patient presented to our radiology practice with severe acute pain localized to their right ribcage. The documentation indicates the radiologist captured posteroanterior (PA), anteroposterior (AP), right lateral (RL), and right anterior oblique (RAO) views to evaluate for a rib fracture. We assigned 71111-52-RT for the procedure, but the claim was denied. How should we have coded this service? Wyoming Subscriber Answer: You need to assign only 71101 (Radiologic examination, ribs, unilateral; including posteroanterior chest, minimum of 3 views) and append modifier RT (Right side) to report this procedure. The documentation lists four views total — PA, AP, RL, and RAO — which meets the “minimum of 3 views” listed in 71101’s descriptor as well as the “posteroanterior chest” requirement. Additionally, you initially assigned 71111 (Radiologic examination, ribs, bilateral; including posteroanterior chest, minimum of 4 views) appended with modifiers 52 (Reduced Services) and RT. Appending modifier 52 to 71111 to show the radiologist captured X-ray views on only one side of the patient’s body is incorrect since 71101 is inherently a unilateral (one side of the body) code. However, you may still append RT to 71101 to specify on which side of the patient’s body the procedure was performed.
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