Radiology Coding Alert

Question: Following a fall, a patient presented to a radiology office for X-rays of their facial bones. The radiologist captured posteroanterior (PA), occipitomental, and lateral views. We billed 70150, but received a denial because another facility not affiliated with our group performed the same procedure. We aren’t sure if the X-rays were performed before or after our visit. We appended modifier 77 to the code on a corrected claim, but received another denial citing the required modifier is missing or invalid.

Is there another modifier that we should use?

Tennessee Subscriber

Answer: Appending modifier 77 (Repeat procedure by another physician or other qualified health care professional) to 70150 (Radiologic examination, facial bones; complete, minimum of 3 views) to indicate the X-rays were separate services by different practitioners is the correct option. For your case, contacting the individual payer to confirm how to proceed is the best next move.

Appending one of the X{EPSU} modifiers to 70150, such as XP (Separate practitioner, a service that is distinct because it was performed by a different practitioner) or XE (Separate encounter, a service that is distinct because it occurred during a separate encounter), could be an alternate option. However, the X{EPSU} modifiers aren’t acceptable modifiers for 70150, so they won’t be accepted by the payer.