Radiology Coding Alert

Question: A patient presented to the emergency department following a fall at home. The patient injured their left hand when they fell. Following the HPI and a physical evaluation, the physician ordered posteroanterior (PA) and lateral X-ray views of the left hand. The provider diagnosed the patient with a dislocation of the left pinky MCP joint. After relocating the digit, the physician ordered an additional two-view X-ray to confirm the relocation was correct. The same radiologist performed both X-ray examinations on the same DOS.

How do I report the multiple X-ray examinations?

Nevada Subscriber

Answer: You indicated the physician ordered posteroanterior (PA) and lateral views of the left hand to evaluate the patient’s injury. You’ll assign 73120 (Radiologic examination, hand; 2 views) to report the first two-view X-ray examination of the patient’s left hand.

Following the relocation of the patient’s finger, the physician ordered an additional two-view X-ray examination, which was performed by the same radiologist on the same date of service (DOS). You’ll assign 73120 once again for this procedure, but you’ll need to append modifier 76 (Repeat procedure or service by same physician or other qualified health care professional) to the code to show it is a repeat procedure by the same provider.

Don’t forget the diagnosis: You’ll assign S63.267A (Dislocation of metacarpophalangeal joint of left little finger, initial encounter) to report the diagnosis, which shows the medical necessity for the multiple X-ray examinations. You indicated the physician diagnosed the patient with a dislocated metacarpophalangeal (MCP) joint of the left pinky, which was then relocated to its original position. The 7^th character “A” identifies that the patient is seeking active treatment for the injury.