# Cpt Code Help



## fisherdawnmarie (Jun 24, 2008)

I have report that reads Right and Left clavicle. Does CPT 73000 include both? 

Thank you


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## dmaec (Jun 24, 2008)

in my opinion, it does - "radiologic examination;clavical, COMPLETE"  yaknow, dangit - I have to rethink this, I just spoke to one of our radiologists and she said, when bilateral is done, they take two separate (actually four because apparently they take two angles per side).  So, I guess in that case, a modifier .50 on it should cover it all


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## sm9jack (Jun 24, 2008)

Use your modifiers to be sure


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## Lisa Bledsoe (Jun 24, 2008)

For xrays use rt and lt.


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## dmaec (Jun 24, 2008)

wouldn't you use the rt/lt if it was one or the other, but the .50 modifier if it's bilateral?


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## mbort (Jun 24, 2008)

I would use the RT/LT modifiers and put a 59 on the 2nd


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## dmaec (Jun 24, 2008)

hmmm, I guess I'd disagree with that.  I rarely use a .59 on xrays - sometimes, but rarely - and not in this instance.


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## Lisa Bledsoe (Jun 25, 2008)

I would only use rt/lt, not -59.


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## mbort (Jun 25, 2008)

The purpose of the 59 modifier on the 2nd is due denials on the second line for duplicate (or whatever other reason they see fit). I've seen this over and over and since I started putting the 59 (seperate site) on the 2nd line, denials have diminished.  

If you were to have a hammertoe 28285-T5 AND 28285-T6, you would have to put the 59 on the 2nd line (28285-59-T6).

X-rays are really no different 

Then again, maybe its just an issue I have with the carriers I submit to.


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## dmaec (Jun 25, 2008)

yes, I see the indicator code is '3', which means you certainly can use the rt/lt on the 73000.   (and apparently it should be reimbursed without multiple procedure fee reduction!)


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## Lisa Bledsoe (Jun 25, 2008)

To further this discussion, I have just found out that TrailBlazer is denying our rt/lt xrays wanting mod -76 on one...what do you all think of that?  Since mod -76 is "repeat procedure" and we are not repeating the procedure on the same site, that seems like an inappropriate modifier to me...


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## mbort (Jun 25, 2008)

I have Trailblazer as my FI too.  You are right, -76 is not appropriate.  I use the -59 on my claim to them.


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## Lisa Bledsoe (Jun 25, 2008)

Do they take a multiple procedure discount when you add the -59?


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## mbort (Jun 25, 2008)

no they do not take a discount for multiple procedures


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## Lisa Bledsoe (Jun 25, 2008)

Super - I appreciate the information!!


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