Radiology Coding Alert

Reader Questions:

Understand Indicator '3' for Mastoids

Question: Are mastoid view codes 70120-70130 unilateral or bilateral?

Utah Subscriber

Answer: Codes 70120 (Radiologic examination, mastoids; less than three views per side) and 70130 (... complete, minimum of three views per side) are unilateral.

Helpful: If you check the "Bilat Surg" column in the physician fee schedule, you'll see a "3" for these codes. According to the fee schedule, that means "bilateral payment adjustment does not apply," and you should charge both sides separately at their normal fee. Most services with a "3" are radiology procedures. You can search the fee schedule online at http://www.cms.hhs.gov/pfslookup/.

To report the procedures bilaterally, check for your payer's preference. You may need to report the code twice and append modifier 50 (Bilateral procedure) to the second code. Or the payer may prefer that you report the procedure as a single line item with 50 appended.

Tip: Likely ICD-9 codes for these procedures include the following:

• 383.x -- Mastoiditis and related conditions

• 386.x -- Vertiginous syndromes and other disorders of vestibular system

• 784.2 -- Swelling, mass or lump in head and neck.

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