Question:
What should we be coding when a patient presents with an order for bilateral complete knee imaging with standing AP views?
Answer:
You count the total number of views performed for each knee and report each knee separately if images of both knees were medically necessary. If the images of one knee were for comparison only, then you would report a code only for the affected knee.
So, if you had four views of the left knee and four views of the right knee, plus the bilateral standing view (all medically necessary), you have five views of each knee, and you would report 73564-50 or 73564-RT and 73564-LT (depending on payer preference for bilateral exams).
73564 | Radiologic examination, knee; complete, 4 or more views |
You cannot report code 73565 (bilateral standing AP) unless that is the only exam performed.
See the CPT Assistant, February 2015 for a Q & A regarding this issue.