Radiology Coding Alert

Question: How should I code AP and sunrise views of both knees with a lateral view of the right knee?

Answer: For the three views of the right knee, you should report 73562 (Radiologic examination, knee; 3 views) with modifier RT (Right side) appended. For the two views of the left knee, report 73560 (... 1 or 2 views) and append modifier LT (Left side). Note that to choose the appropriate codes, you count the views performed on each knee and code each knee separately.

Beware: Some payers may require modifier 59 (Distinct procedural service) on 73560 to override an edit bundling the code for one or two views (73560) into the code for three views (73562). Check with individual payers for their modifier requirements.

Views: The AP (anteroposterior) view shows the straight knee from the front. For the sunrise view, the tech positions the knee in a flexed position and the beam is tangential to the patella (kneecap) so that the final image makes it look as if the patella is rising over the horizon. The lateral view images the side of the knee.