Radiology Coding Alert

Question: I’m very new to medical coding and just started my career with a medical coding practice. I have a radiology report where the provider captured posteroanterior (PA), oblique, and lateral views of the patient’s left middle finger. The findings indicate a dorsal proximal interphalangeal (PIP) joint dislocation of the finger. This is the patient’s first visit to the outpatient imaging clinic.

What codes should I assign for this encounter?

Wyoming Subscriber

Answer: You’ll assign 73140 (Radiologic examination, finger(s), minimum of 2 views) and append it with F2 (Left hand, third digit) to report the imaging procedure. You’ll also assign S63.283A (Dislocation of proximal interphalangeal joint of left middle finger, initial encounter) to report the diagnosis.

To locate the procedure code, you’ll turn to the CPT^® code set Index and look for fingers under the X-ray section. You’ll find one code listed, which you can verify in the Radiology section of the code set. You’ll always want to double check the medical record since the radiologist must capture at least two X-ray views of the patient’s finger(s) to correctly report 73140. In your situation, the radiologist captured PA and lateral views, which fulfills the requirement for the code.

While this is a scenario where you can report the complete code without modifiers 26 (Professional component) or TC (Technical component …), appending a digit-specific modifier may be required depending on the payer preferences. This is why you’ll append F2 to 73140 to indicate the provider imaged the middle finger of the left hand.

Next, you’ll turn to your ICD-10-CM code set to locate the diagnosis code. The radiologist’s findings list the injury as a dorsal PIP joint dislocation. In the Alphabetic Index, track the following indentations to locate the code to verify:

• Dislocation > finger > interphalangeal > proximal > middle

In the Tabular List, you’ll find the provider’s diagnosis: S63.283A.

Define dorsal: The radiologist’s findings listed “dorsal” in reference to the patient’s injury. This term is used to define where the bone was displaced:

• Dorsal dislocation: Finger bone is moved toward the back of the hand.
• Volar dislocation: Finger bone is moved toward the palm.
• Lateral dislocation: Finger bone is moved to the side.