# Bilateral hip xrays



## grandmacora

We are having a problem getting bilateral hip xrays paid from the insurance we bill 73510 with a rt and lt they come back and say only 1 unit is allowed per day we tried a 50 and they do not like that either. Can we bill the 73520 even if the doc does not take a pelvis xray???  Or any other ideas?

Thank you


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## pallen

Are you using modifier 76? 73510.RT and 73510.76LT. ??


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## mitchellde

pallen said:


> Are you using modifier 76? 73510.RT and 73510.76LT. ??



You cannot use modifier 76 for this since both are performed at the same time.  A 76 is for a repeated service in a different session and it must be the same service so when you do a rt and then a lt it is not really the same procedure.

However this code is used for one hip only if you have a bilateral film you must use the code for the bilateral hip with no modifier and 1 unit.  The code is I think 73520 but check first I am going from memory.


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## tmlbwells

If it states that only the views of the hips were done with no pelvis do you put a 52 modifier on it?


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## mitchellde

I do not have my coders desk reference with me but that would answer your question.  I do not however think so.


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## tdml97@yahoo.com

There is a code for bil hip x-ray -- 73520 - Radiologic exam,hips,bilateral,min of 2 views of each hip, including anteroposterior view of pelvic

Hope this helps


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## donnajrichmond

grandmacora said:


> We are having a problem getting bilateral hip xrays paid from the insurance we bill 73510 with a rt and lt they come back and say only 1 unit is allowed per day we tried a 50 and they do not like that either. Can we bill the 73520 even if the doc does not take a pelvis xray???  Or any other ideas?
> 
> Thank you



What views did you take?  
According to AMA and ACR, typically this is AP pelvis and 1 additional view of each hip (the pelvis replaces individual AP views of each hip).  If you don't do a pelvis, code 73520-52.


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## Chitra

Hi,

If single view of each hip is taken without pelvis , the code should be 73520-52, if 2 views of each hip is taken, then it should be coded as 73510-rt and 73510-lt.


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## mitchellde

You would not code the 73510 with an RT and LT as it is a unilateral only, you would not use this if 2 views of each hip are taken.  73520 is a minimum of 2 views, so it will cover even if 2 views of each hip are taken
Here is what the AMA says
AMA Comment

According to the American College of Radiology, an anteroposterior (AP) view of the pelvis, as well as additional views of both hips, is the appropriate method of examination when a bilateral hip study is ordered. In addition to the AP view of the pelvis, at least one more view of each hip, typically a coned-down frog leg lateral view, is obtained amounting to three views: one AP view of the pelvis which includes both hips; one frog-leg lateral of the right hip; and one frog-leg lateral of the left hip.

However, if a bilateral study is performed without an AP view of the pelvis, then code 73520, Radiologic examination, hips, bilateral, minimum of two views of each hip, including anteroposterior view of pelvis, may be reported with modifier -52, Reduced services, appended to indicate that the study was not performed in its entirety. CPT code 73510, Radiologic examination, hip, unilateral; complete, minimum of two views, is not intended to describe a bilateral hip study, but a complete radiological examination with a minimum of two views performed on a single hip.


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## mmelcam

So do that mean that you would code 73520-52 (reduced services) for either of these scenarios:

1 view RT hip, 1 view LT hip, no pelvis (ordered & performed together)

                -or-
2 views Rt hip, 2 views LT hip, no pelvis (ordered & performed together)


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## drr66

*AP Pelvis and Lateral of Bilateral Hips*

Please help, our doctors are doing an AP pelvis and lateral of each hip.  We've been coding as 72170, 7350059RT and 7350059LT.  Medicare is telling us there is a different valid code is available for this pelvis and hip x-rays.  We are thinking may 73520 but that is for an AP pelvis, bilateral hips minimum of two views, and we are only doing one view of each hip.  Should we be using this code with a modifier 52?  

You're help is greatly appreciated!!

Deirdre


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## elena.delucia

Per CSI book, "if a bilateral study is performed without an AP view of the pelvis, it would be appropriate to report code 73520-26-52 to indicate that the study was not performed in its entirety."  

So if you did 2 views of each hip but no pelvis it would be 73520-26-52. 

If you did only 1 view of each hip and no pelvis it would be 73500-26-rt and 73500-26-lt. 

However if you do 1 view of each hip and 1 view pelvis then it would be 72170-26, 73500-26-rt, 73500-26-lt


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## Thath041

Here is my scenario;
Ordered as: unilateral complete minimum 2 views;
Technique : AP pelvis and 2 views of the left hip .
However actual films are below:

AP view pelvis with 1 frog leg lateral hip ? It was coded as 73510 and 72170
I think it should just be the 73510 

Is the AP Pelvis on a unilateral view included in the hip views for 73510? Instead of reporting it separately as 72170


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