Radiology Coding Alert

Question: A patient was referred to our radiology practice for X-rays of the patient’s left shoulder. The patient presented complaining of pain in the shoulder when raising and lowering their arm. The radiologist captured and interpreted two X-ray views of each of the patient’s shoulders to compare the joints.

How should I report the encounter?

Ohio Subscriber

Answer: The CPT^® code set contains two codes related to X-rays of the shoulder — 73020 (Radiologic examination, shoulder; 1 view) and 73030 (… complete, minimum of 2 views). Since the radiologist captured two views of each of the patient’s shoulders, you’ll assign 73030.

You’ll also need to append modifier 50 (Bilateral procedure) to show that you’re reporting X-rays to both shoulders. However, if the radiologist captured two X-ray views of one shoulder, then you’d append 73030 with modifier LT (Left side) or RT (Right side) to indicate laterality.

Of course, you should review your individual payer preferences to know which modifiers (such as 50 or LT/RT) are necessary for your report.