Radiology Coding Alert

Question: The referring physician ordered a chest X-ray with 2 views and a sniff test. How do we report this? Please suggest the correct CPT® codes. Is it correct to code 71020 with 76000 or is CPT® code 71023 a better option? Please opine.

Florida Subscriber

Answer: You will not be correct to separately report the chest X-ray and fluoroscopy with 71020 (Radiologic examination, chest, 2 views, frontal and lateral) and 76000 (Fluoroscopy [separate procedure], up to 1 hour physician or other qualified health care professional time, other than 71023 or 71034 [e.g., cardiac fluoroscopy]). The best choice here is to report 71023 (Radiologic examination, chest, two views, frontal and lateral; with fluoroscopy) if the procedure produces a two-view chest x-ray with the fluoroscopic test. For four or more views, you report 71034 (Radiologic examination, chest, complete, minimum of four views; with fluoroscopy).

You should report 76000 if your radiologist produces no films during the procedure. Your payer may not cover a sniff test with no films, but you must code the procedure as performed.

Sniff test: This is a type of chest fluoroscopy. During this test, your radiologist observes how the diaphragm, the muscle sheet that controls breathing, moves during normal and rapid breathing. The sniff test is so called because the patient is asked to sniff or breathe quickly through the nose. If the nerve supplying the diaphragm (phrenic nerve) is diseased, the diaphragm is paralyzed and the movements of the diaphragm are affected. During the course of normal breathing, the diaphragm moves synchronously on both sides, down during inspiration and up during exhalation.