# Chest Xrays Following CT Guided Lung Biopsy



## tfrick2 (Dec 3, 2012)

Hello All,

I have a patient who had a CT guided lung biopsy. Immediately after the biopsy, a chest XRay was taken to check for pneumothorax. Four hours later, a second CXR was done, again to check for pneumothorax. 

According to information I found, it looks like follow-up chest xrays are standard procedure, which makes me wonder whether they should be charged separately. 

Any direction on this would be appreciated.


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## jgf-CPC (Dec 5, 2012)

I found this in SuperCoder  and since I don't know the codes that were used or if the same Dr. interpreted I copied this all for you: 

Modifier -59, -76, TC, -26, etc. would be used according to documentation.
Following is an example of the proper use of modifier -59:

A patient has a chest X-ray (code 71020) at 10 a.m. A second chest X-ray (code 71010) is taken at 3 p.m. The -59 modifier should be added to code 71010 to indicate the X-rays were done at separate times. This is a different session or patient encounter.

When radiologists interpret two x-rays on the same day that require the same code, proper use of modifier 76 (Repeat procedure or service by same physician) should be used.

Scenario: A physician performs two chest x-rays (71010, Radiologic examination, chest; single view, frontal) on a patient with chest pain. The same radiologist interprets both films.
Solution: When repeating the x-ray is medically necessary, you should report the first service as usual and append modifier 76 to the second. Note that if you're reporting only the interpretation, you should append modifier 26 (Professional component), as well.
Example: You report:
• 71010-26
• 71010-26-76.

A chest x-ray (71020, Radiologic examination, chest; 2 views, frontal and lateral) includes both technical and professional components. If you're reporting only the technical component, report 71020 and append modifier TC (Technical component); if you're reporting only the professional component (performing the test only), append modifier 26 (Professional component) instead. If you're coding for both the test and its reading, simply report 71020 with no modifiers.


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