Wiki hip x-ray denial, anyone else getting this?

[kdsampson]

Dr. ordered a one view of both RT & LT hip. We are billing 73500 twice for RT & LT, it states Radiologic exam, hip, unilateral; 1 view. Ins is stating there is a more appropriate code to use, but I'm not seeing anything in the cpt for 1 views of hip. Any advice?

 

[lostone65]

Denial of 73500

We have been getting this type of denial quite often on hip and pelvis x-rays. They want you to bill 73520 which is one code for bilateral, however it is 2 views. We have had success in appeals, but it takes a long time. We have a form letter explaining why we need only one view or both hips. they are doing the same thing if we bill hip and pelvis x rays. They are wanting us to use only the plevis. Again we appeal with letter and it gets paid. Hope this helps you.

 

[jgf-CPC]

What insurance company is it? Have you tried appending the 50 modifier? for bilateral? It really depends on the insurance company as to which modifier we use. Hope this helps!