# Radiology expert out there!  HELP...



## rthames052006 (Oct 7, 2011)

Hello:

First I will start off by saying I have basically no experience in this specialty but I am now getting a question...

This is what I have so far.

Patient had 2 xrays  of both right and left hands = cpt code 73120 RT, 73120 LT.
( I am also toying around with asking the possibility of using cpt code 73130 instead of the 73120 because this code ( 73130) states a minimum of 3 view and we have a total of 4)  Just some random thoughts- my thought process.

Patient also had 2 xrays of the right thumb- I know we can't use 73140 because it clearly states in  the Coders Desk Reference for Procedures that this code is for the 2nd thru 5th digits only, not the thumb.  

My question is I can't find any documentation that say that the thumb would be included in the hand xray and with me not having the experience in Radiology I wanted to ask an expert.  

Also after the xrays were taken and reviewed it did show that the patietn has a non displaced fracture of the thumb.

Any takers out there on this....

TIA


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## donnajrichmond (Oct 7, 2011)

rthames052006 said:


> Hello:
> 
> First I will start off by saying I have basically no experience in this specialty but I am now getting a question...
> 
> ...



73120 and 73130 are hand (singular) - you can't take the total # of views from both hands and combine them into one code.  code each hand separately.  In your case, 73120-RT and 73120-LT (or 73120-50, or 73120 x 2 depending on payer preference.) 

Coders Desk Reference is NOT a good reference for Radiology.  It has had many errors and this is one.  Thumb is coded with 73140.  For reference, see Clinical Examples in Radiology, Spring 2011.  From Dorland's Medical Dictionary, "thumb - the first digit of the hand; it is the most preaxial of the five fingers, having only the two phalanges and being apposable to the other four fingers.  Called also digitus primus (I) manus  and first finger. "


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## jgf-CPC (Oct 7, 2011)

You also have to look at what the physician has ordered and this is what has to be done. Donna coded it correctly but you cannot change codes from what is ordered by the referring physician.


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## rthames052006 (Oct 7, 2011)

donnajrichmond said:


> 73120 and 73130 are hand (singular) - you can't take the total # of views from both hands and combine them into one code.  code each hand separately.  In your case, 73120-RT and 73120-LT (or 73120-50, or 73120 x 2 depending on payer preference.)
> 
> Coders Desk Reference is NOT a good reference for Radiology.  It has had many errors and this is one.  Thumb is coded with 73140.  For reference, see Clinical Examples in Radiology, Spring 2011.  From Dorland's Medical Dictionary, "thumb - the first digit of the hand; it is the most preaxial of the five fingers, having only the two phalanges and being apposable to the other four fingers.  Called also digitus primus (I) manus  and first finger. "



Thank you so much for the clarification Donna!  I appreciate your help.  Unfortunately we do not have the Clinical Examples Spring 2011, when I went to the shelf to reference it, I saw the big "  This is your LAST ISSUE" comment so the last one we have here ins Winter 2011.

By chance, are you willing to share with me what it says via personal email?

If so it's rthames@heritagemedgrp.com

So my 1st thougth was correct to code 73120 RT and 73120 LT, i will double check what payor this is to know if I am adding modifier 50 or just the LT and RT and will also code the 73140 for the thumb views too.

Again, thank you very much, I appreciate it!  As I always say... I learn something new everyday in this business


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## RADCODER (Oct 10, 2011)

FYI, you might also need to ADD a "59" modifier to the 73140, as the thumb and hand are 9/10 incidental of each other. *Also make sure the Left hand was not done as a comparison to the Right, you usually can not bill for comparisons as they are not medically necessary.


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## rthames052006 (Oct 10, 2011)

Thank you all for your help.  I  did get the info I needed from the Radiology publication by AMA.  I can use 73120 RT, 73120 LT and 73140- 59.

Very much appreicated!


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