Radiology Coding Alert

Question: Is there a separate code for reporting x-rays taken using portable equipment? I don't usually code these services, and I'm not sure which code to report.

Answer: If you are reporting only the interpretation (professional component) of the service, you should report the same service code from the 70010-79999 range you would report for non-portable services. Report a place of service (POS) code reflecting where the doctor performed his service.

Example: The radiologist interprets a two-view chest x-ray taken at a physician office using a portable device. You should report his service with 71020-26 (Radiologic examination, chest, two views, frontal and lateral; professional component) and POS 11 (Office).

To report the transportation, use R0070 (Transportation of portable x-ray equipment and personnel to home or nursing home, per trip to facility or location, one patient seen) when the personnel see one patient and R0075 (Transportation of portable x-ray equipment and personnel to home or nursing home, per trip to facility or location, more than one patient seen) to report imaging multiple patients at the same location.

• UN -- Two patients served
• UP -- Three patients served
• UQ -- Four patients served
• UR -- Five patients served
• US -- Six or more patients served.

Key: Report R0070 and R0075 when you transport the equipment, not when the facility the personnel travel to stores the equipment.

Example: You need to report portable x-ray transportation and a global two-view chest x-ray for one patient and a complete ankle x-ray for a second patient at a skilled nursing facility (SNF).

You should report 71020 and R0075-UN for patient one and 73610 (Radiologic examination, ankle; complete, minimum of three views) and R0075-UN for patient two. Medicare will prorate R0075 payment between the two patients. For the services provided at the SNF, you should report POS 31 (Skilled nursing facility).

Coverage: CMS recently clarified its portable x-ray coverage, adding the items in italics:

• Skeletal films involving the extremities, pelvis, vertebral column or skull;
• Chest films which do not involve the use of contrast media (except routine screening procedures and tests in connection with routine physical examinations);
• Abdominal films which do not involve the use of contrast media; and
• Diagnostic mammograms if the approved portable x-ray supplier... meets the certification requirements (www.cms.hhs.gov/transmittals/downloads/R71BP.pdf).