Orthopedic Coding Alert

Question: If the orthopedic surgeon interprets three views of a patient's wrist, plus posteroanterior and ulnar deviation wrist views taken at the same session, may I report 73110 and 73100?

Rhode Island Subscriber

Answer: You should report only 73110 (Radiologic examination, wrist; complete, minimum of three views) -- not 73100 (- two views).

Reason: Code 73110 specifies "minimum of three views." That means you should report 73100 if the surgeon reads three or more views. You should not report 73110 for three views and 73100 for two views.

If you report the two together, payers who apply Correct Coding Initiative (CCI) edits will reimburse only for 73110 because CCI bundles 73100 into 73110. The situation you describe doesn't meet the requirements for overriding the edit -- such as separate anatomic area or separate session.

Don't forget: Append modifier 26 (Professional component) if your surgeon performs only the professional component of the exam.