Radiology Coding Alert

Rely on this comprehensive list of all new diagnostic radiology CPT^® changes.

As all experienced coders know, with the new year comes a brand-new set of specialty-specific CPT^® codes. This year offers another vast array of new, revised, and deleted codes that you should prepare for sooner, rather than later.

From a diagnostic radiology perspective, this year incorporates changes to some of the most foundational radiology codes: chest and abdominal X-rays. While this might initially sound inconvenient, you will see that this new set of codes are designed to simplify the coding process for chest and abdominal imaging.

Keep reading for a complete breakdown of 2018 diagnostic radiology coding changes.

Get to Know these New Chest X-ray Codes

Starting in January, the following chest X-ray codes will be deleted:

• 71010, Radiologic examination, chest; single view, frontal
• 71015, Radiologic examination, chest; stereo, frontal
• 71020, Radiologic examination, chest, 2 views, frontal and lateral
• 71021, Radiologic examination, chest, 2 views, frontal and lateral; with apical lordotic procedure
• 71022, Radiologic examination, chest, 2 views, frontal and lateral; with oblique projection
• 71023, Radiologic examination, chest, 2 views, frontal and lateral; with fluoroscopy
• 71030, Radiologic examination, chest, complete, minimum of 4 views
• 71034, Radiologic examination, chest, complete, minimum of 4 views; with fluoroscopy
• 71035, Radiologic examination, chest, special views (eg, lateral decubitus, Bucky studies)

In their place, you will be reporting one of the following new codes:

• 71045, Radiologic examination, chest; single view
• 71046, Radiologic examination, chest; 2 views
• 71047, Radiologic examination, chest; 3 views
• 71048, Radiologic examination, chest; 4 or more views

"As you can see, your duties coding chest X-rays of different views and angles becomes drastically simpler. As of 2018, you will no longer take the type of view performed into consideration when coding chest X-rays," says Lindsay Della Vella, COC, medical coding auditor at Precision Healthcare Management in Media, Pennsylvania. "Rather, you will simply count the number of views taken to determine the correct CPT^® code," Della Vella explains. For example, you will designate code 71045 for all single view chest X-rays (previously codes 71010 and 71015). For all two-view X-rays, you will now use code 71047. For code 71035, you will determine the correct code based on the number of special views the provider performs.

As for fluoroscopy, you will need to familiarize yourself with this revision to code 76000:

• 76000, Fluoroscopy (separate procedure), up to 1-hour physician or other qualified health care professional time, other than 71023 or 71034 (eg, cardiac fluoroscopy).

Since the fluoroscopy/chest X-ray combination codes will be deleted in 2018, you will apply code 76000 to any chest X-ray incorporating fluoroscopic guidance. "The changes to chest and abdominal X-ray codes coupled with the revision to fluoroscopy code 76000 will take away any ambiguity a coder may face when combining these procedures," says Amanda Corney, MBA, medical billing operations manager for Medical Resources Management in Rochester, New York. "With the deletion of the chest fluoroscopy combination codes in 2018, coders will now be able to apply 76000 to any chest or abdominal x-ray utilizing fluoroscopic imaging," Corney explains.

Don't Forget these New Abdominal X-ray Codes

In addition to the changes to chest X-rays, CPT^® will incorporate a new set of three abdominal X-ray codes.

Beginning in January, the following abdominal X-ray codes will be deleted:

• 74000, Radiologic examination, abdomen; single anteroposterior view
• 74010, Radiologic examination, abdomen; anteroposterior and additional oblique and cone views
• 74020, Radiologic examination, abdomen; complete, including decubitus and/or erect views

In their place, the following three new codes will be implemented:

• 74018, Radiologic examination, abdomen; 1 view
• 74019, Radiologic examination, abdomen; 2 views
• 74021, Radiologic examination, abdomen; 3 or more views

As you can see, these new abdominal codes simplify the coding process so the coder only differentiates codes by number of views, not type of view. All in all, this should offer relief to those coders who occasionally have to send reports back to the provider for elaboration on which views were performed.