Wiki Billing for knee xrays???

[rjenn86]

I have a question I hope someone can answer for me. I code for orthopedic and the doctors see a lot of pt's for the knees. If a pt is coming in due to LT knee pain, the xrays that are taken are usually of both the LT and RT or vice versa. I have always billed out both views, LT and RT to insurance as that was how the past coder billed them out, as well as the doctor dictates both views.

My question is should we bill out for both views as it is dictated in chart note or just bill out the view for the knee that the pt is being seen for. (For Example, 4 views LT and 3 views RT) I would bill to ins 73564/LT and 73562/RT...

Thank you.

 

[johnmeyer]

You are right in your thinking. You should bill out what is in the chart note.

Don't forget that the chart note is your supporting document to let you know what you need to code. This is what the insurance companies will ask for to support what you code.

If the chart note says 4 views of the left and 3 view of the right, then you should code 73564-LT and 73562-RT, just like in your example. If your doctor tells you that he/she did something that is not in the note, then you need to tell them to add that to their note before you can code it because if it's not in the note, then you really can't code it.

Hope that helps.