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Orthopedic Coding Alert

Reader Question:

Extra Coccyx View Is Included

Published on Thu Oct 02, 2003

Question: Our orthopedist ordered a coccyx x-ray, but our radiology technologist took two views instead of just one. Should we report 72220? Should we append modifier -52 because he didn't order the second view?

California Subscriber Answer: Although the descriptor for 72220 (Radiologic examination, sacrum and coccyx, minimum of two views) refers to at least two views, and your physician only ordered a "coccyx x-ray," you may be able to bill for the full service. In this situation, review the procedural report to determine if your practice obtained and interpreted one view or multiple views (as part of a coccyx study).  Internal protocols may dictate that more than one view is necessary, and only the procedural report will provide
this information.
 
If you determine that the radiology technologist only obtained one view, you should append modifier -52 (Reduced services) to 72220. If he or she obtained multiple views, you should report 72220 without any modifiers appended.
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