Radiology Coding Alert

Question: Our clinic radiologist interpreted two single-view chest x-rays for the same patient on the same date of service, but each x-ray was ordered by a separate physician. How should I report this? Delaware Subscriber


Answer: You should report 71010 (Radiologic examination, chest; single view, frontal) and 71010-76 (Repeat procedure by same physician) for the radiologist's interpretation of these two films.


Even though two different physicians ordered the x-ray, you are reporting the same procedure (chest x-ray interpretation) repeated by the same radiologist on the same date of service.

You should also determine whether you need to append modifier 26 (Professional component) if the radiologist only provided the interpretation and you aren't coding for the technical component.


Note: If a patient receives two chest x-rays and they are interpreted by different physicians in the same group, you should report 71010, 71010-77 (Repeat procedure by another physician).


Hospital hint: The rule is a little different for hospital exams when you're coding for the hospital.

Medicare says that the hospital should use modifier 76 if the same physician orders both exams and modifier 77 if a different physician orders each one.

The Medicare Claims Processing Manual, chapter 4, section 20.6.5, says that if the hospital coder doesn't have access to the ordering physician's identity, use the interpreting radiologist's identity instead (if the same radiologist reads both x-rays, the hospital would use modifier 76).


The answers for You Be the Coder and Reader Questions were reviewed by Jackie Miller, RHIA, CPC, senior consultant with Coding Strategies Inc. in Powder Springs, Ga.