Question:

Instead of billing CPT® codes 71100 and 71046 together with a -59 modifier on the chest X-ray, should we bill 71101 instead?

Answer:

If a rib series (71100 or 71110) plus a single posteroanterior (PA) view of the chest (71045) is performed at the same session, then 71101 or 71111 would be reported instead of the individual rib and chest codes.

However, if a two-view chest (71046) is performed along with a rib series (71100 or 71110), then the individual codes, not the combination codes, are reported.

71046 Radiologic examination, chest; 2 views
71101 Radiologic examination, ribs, unilateral; including PA chest, minimum of 3 views
71111 Radiologic examination, ribs, bilateral; including PA chest, minimum of 4 views

The fall 2016 issue of Clinical Examples in Radiology included the following information in a discussion concerning a bilateral ribs and chest x-rays case:

When a bilateral rib study is ordered and performed and a posterior-anterior (PA) chest view is included with at least 4 views, CPT code 71111, Radiologic examination, ribs, bilateral; including posteroanterior chest, minimum of 4 views, is reported. Alternatively, when a PA and a lateral chest X-ray study is ordered and performed at the same time as a bilateral rib study, it would be appropriate to report codes 71046 (2-view chest) and 71110 (bilateral ribs). Whenever more than 1 view of the chest is performed in conjunction with a bilateral or unilateral rib X-ray, the study should be reported with both the appropriate chest X-ray code based on the number of views taken and the appropriate rib X-ray code.


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This question was answered in an edition of our Radiology Compliance Manager. For more hot topics relating to radiology services, please view our store, or call us at 1.800.252.1578 ext. 2.

 

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Fee schedules, relative value units, conversion factors and/or related components are not assigned by the AMA, are not part of CPT, and the AMA is not recommending their use. The AMA does not directly or indirectly practice medicine or dispense medical services. The AMA assumes no liability for data contained or not contained herein.

CPT is a registered trademark of the American Medical Association.