Radiology Coding Alert

Question: I have a report for a two-view and single-view chest x-ray performed on the same date of service. The physician ordered the two-view first and then had to order the single-view after the patient pulled his chest tube out. How can I code for both of these to avoid a denial?


South Dakota Subscriber

Answer: Report 71020 (Radiologic examination, chest, two views, frontal and lateral) for the two-view. Then report 71010 (Radiologic examination, chest; single view, frontal) and append modifier 59 (Distinct procedural service) to the single-view code.

Why? National Correct Coding Initiative (NCCI) edits bundle 71010 into 71020, but the edit has a modifier indicator of "1." The 1 indicator tells you that you may override the edit when appropriate, specifically when the second service is performed at a separate encounter or at a separate anatomic site.

Because the single-view was clinically necessary (following the patient removing his chest tube) and a separate encounter, you may override the edit. Append modifier 59 to the column 2 code, 71010.