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Radiology Coding Alert

READER QUESTIONS:

Documenting Views Prevents Upcoding Snag

Published on Sat May 09, 2009

Question: If the radiologist doesn't state the number of views for a hand x-ray, do I need to append modifier 52 to 73120? Colorado Subscriber Answer: Your best bet is to ask the radiologist to amend and sign the report to document how many views he interpreted, and then code accordingly. If you report a code that requires two views, but you don't have documentation of two views, an auditor may consider this upcoding and typically will reduce the claim to the lowest reportable code. For a 73120 (Radiologic examination, hand; 2 views) claim that doesn't have supporting documentation of the number of views, this may mean paying you for only one view. If you can't get confirmation from the radiologist of the number of views, appending modifier 52 (Reduced services) may save you future hassles.
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