# Multiple same site x-rays for pre and post reduction of fractures/dislocations



## SienTC1720 (May 24, 2016)

We are having a hard time deciding how to bill for these types of procedures. It is multiples of the exact same study, i.e. shoulder x-ray for a dislocation, the first study to see the problem, and the second/subsequent to make sure it is set correctly.

My first question is, since these are all done on the same day, do they ALL have the A suffix on the diagnosis? It seems they shouldn't, but they aren't exactly separate encounters.

Then, how should we be billing these so that we will get both units paid? As 2 units on one side, or as separate line items with a -59 on everything but the first?

Thanks in advance for any help!


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## mitchellde (May 24, 2016)

Yes the diagnosis gets the A as it is still the active treatment encounter.  Second you bill the X-rays on separate lines using the 76 or 77 modifier on the second line.  76 if the same physician ordered each one.


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