Forum - Questions & Answers

Sep 5th, 2011 - badal106 1 

Knee Xray Coding confusion

Please guide and provide me the correct coding for the below mentioned request. Our doctor requests the following, what will be the appropriate code for this:

Right knee:
1: AP View - Right Knee 2: Lateral view at 45 degree flexion(condyles overlapping)-Right knee. 3: Merchants view both knees (Skyline view with knee between 30-45 degree flexion)



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Sep 6th, 2011 - jschmutz   323 

re: Knee Xray Coding confusion

When additional views are done with the standing AP bilateral, you count the views for each knee and code the appropriate codes by number of views.

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Sep 12th, 2011 - badal106 1 

re: Knee Xray Coding confusion

Dear jschmutz thanks for the reply. So what i understand from your reply is that we should have to add the views of both knees with the single knee views. am i right? thanks in advance

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Sep 15th, 2011 - jschmutz   323 

re: Knee Xray Coding confusion

Radiology Compliance Question:
How would you code the following x-ray exam: bilateral standing, including both right and left knees in one shot, lateral left knee, bilateral sunrise view, including both right and left knees in 1 shot?


Radiology Compliance Answer:
You would code 73560-RT and 73562-LT. Code 73565 can be coded only if it is the only exam done. When additional views are done with the standing AP bilateral, you count the views for each knee and code the appropriate codes by number of views.


Radiology Compliance Question
When I have an order for knee, three views (73562), and also anteroposterior (AP) standing bilateral (73565), I get rejections. Should this be billed as is with a modifier 59, or should the exams be combined for billing purposes into knee 4+ views (73564). The same question applies when knee, three views bilateral with AP standing bilateral is performed.


Radiology Compliance Answer
Code 73565 should be billed when it is the only exam done. When the AP standing view is done with other views, then assign the appropriate code according to number of views. If you do AP standing bilateral along with three additional views of the right knee you would assign 73564-RT and 73560-LT.

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