Radiology Coding Alert

Question: Our physician obtained three shoulder views. Is 73030 the correct choice for reporting this service? Can we report code 73020-59?

Answer: When you have a code that specifies a minimum number of views, and the documented number of views meets or exceeds that minimum, you should only report that “minimum” code.

Check minimum view requirement: For three shoulder views, you report code 73030 (Radiologic examination, shoulder; complete, minimum of two views). The ‘three views’ meets or exceeds the two-view minimum that the code requires.

Not correct: You should not report three shoulder views with 73020-59 (… one view; Distinct procedural service) for one view and 73030 to report the other two views.

CMS Rule: The CMS National Correct Coding Policy Manual, Chapter 9, explains that “CPT^® code descriptors which specify a minimum number of views should be reported when the minimum number of views or if more than the minimum number of views must be obtained in order to satisfactorily complete the radiographic study. For example, if three views of the shoulder are obtained, CPT^® code 73030, one unit of service, should be reported, not 73020 and 73030.”