Radiology Coding Alert

Reader Question:

Comparison X-ray

Question: Can we code and bill for comparison films taken to establish a diagnosis? For instance, how would we code our services if the originating physician orders an x-ray of the right ankle to compare it to an injured left ankle?

Minnesota Subscriber

Answer: Many experts assert that, when clinically indicated, comparison views may be billed and paid. However, providers who routinely obtain comparison views may have difficulty justifying the practice if a payer audits the practice.

There are disagreements about which ICD-9 code is appropriate for the comparison view. Some suggest the use of the same code that justified the original study, although most recommend assigning V70.7 (examination for normal comparison or control in clinical research). Coders may assign this code with the examination code in the example given, 73600 (radiologic examination, ankle; two views). Some coding experts disagree altogether and say comparison views cannot be billed at all. Coders should ask individual payers for their policies.


You Be the Coder and Reader Questions were answered by Donna Richmond, CPC, radiology coding specialist with Acadiana Computer Systems Inc., a medical billing management company based in Lafayette, La., which serves more than 200 radiologists, pathologists and anesthesiologists.