Radiology Coding Alert

Question: Should a single-view chest and unilateral rib series be CPT 71101 (Radiologic examination, ribs, unilateral; including posteroanterior chest, minimum of three views)? Virginia Subscriber Answer: A complete study of a rib or ribs on one side of the chest is almost always performed with at least two views of the anatomic area in question. These two views (minimum) of the rib(s) are taken with a radiographic technique specifically designed to enhance the evaluation of the bony structure of the rib(s). These views may be obtained either with or without an accompanying chest radiograph (generally performed as a single-view chest).

The two rib views and the one chest radiograph compose the minimum of three films demanded by code 71101. Based on your description, a single-view chest and unilateral rib study which should be interpreted by an astute coder as "two" views of the affected bony structures would best be described with 71101, as you suggest. Some confusion about the usage of 71100, which encompasses two views of the ribs only and no accompanying chest film, and 71101, which includes the posteroan-terior chest within the minimum of three views (i.e., one-view chest and two views of the ribs), arises from the fact that CPT descriptions do not always match up well with the established imaging-views protocols found in many radiology departments.

Radiology tech training programs and many department protocols would consider a request for a unilateral rib exam to mean three views of the ribs only: An AP or PA, depending on where the injury is Plus, two oblique views. The above examination would be coded with 71100 because it contains the minimum two views of the ribs but no chest radiograph. It is difficult to call a single AP of the ribs a "chest" because for ribs it typically includes only one side of the thorax. And the exposure technique may be different than that for a chest and often uses a different type of film. The answers for Reader Questions and You Be the Coder were reviewed by Cindy Parman, CPC, CPC-H, RCC, co-owner of Coding Strategies Inc., an Atlanta-based firm.