CPT code 73562 with 73565


Albany, NY
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73562 is a column 2 edit for 73565 but this is a combination that we often do in the office. I have had suggestions to append the 59 modifier to 73562 but since we do this combination often that seems like overuse of 59 modifier. Some have suggested billing 73560 instead of 73562 or to bill 73564 instead of 73562 and 73565 together. Any input would be greatly appreciated.


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73562 with 73565

I don't know if you have found the other thread in regard to this problem, but here is what is posted in a thread from 2009:

Clinical Examples in Radiology (Fall 2006) says-
Code 73565 is used for a standing view of both knees when morphology (form and structure) is examined. This examination is performed typically on patients with osteoarthritis and for presurgical planning.
This code should be reported when the anteroposterior (AP) standing view is the only view taken. This code should not be used for studies involving two or three views of each knee even if one of the views happens to be upright (see codes
73560, Radiological examination, knee; one or two views;
73562, Radiological examination, knee; three views; and
73564, Radiological examination, knee; complete four or more views, to report radiological examination of the knee).

This has clarified the issue for me in my office.