Coders are still having confusion in using some of the radiology cpt codes. This is very common because of the small or slight difference between procedure codes. Also, I have seen that coders makes lot of mistakes when they have to use a combination codes. Today, I would just to share an example of CPT code 73521, which is very confusing to use for medical coders.
CPT code 73521 description
The use of procedure code 73521 should be made only for bilateral procedure of hip. Also, the procedure should include pelvis when performed. Hence both RT and LT hip, along with pelvis of minimumb 2 views should be reported with CPT code 73521. Their are other related CPT codes as well which I have shared below. Always check the number of views before assigning any unilateral or bilateral CPT code for hip and pelvis. The CPT codes are differentiated merely on basis of laterality and number of views.
73521-Radiologic examination, hips, bilateral, with pelvis when performed; 2 views
A radiological exam is taken of the hips and pelvis. For a front to back (AP) view, the patient is placed supine with toes inverted. For a frogleg view, the knees are bent as much as possible with the soles of the feet touching each other. Report 73521 for two views; 73522 for three to four views; and 73523 for a minimum of five views.
Other related CPT codes for hip 73521
73501 Radiologic examination, hip, unilateral, with pelvis when performed; 1 view
73502 ; 2-3 views
73503 ; minimum of 4 views
73522 Radiologic examination, hips, bilateral, with pelvis when performed; 3-4 views
73523 Radiologic ex amination, hips, bilateral, with pelvis when performed; minimum of 5 views
Do not use any 50 modifier for Hips bilateral X rays procedure. The CPT coding guidelines does not allow use of 50 modifier when bilateral CPT codes are available for coding. For example, if a bilateral hip exam with pelvis is performed with minimum 2 views, then the coder should report directly CPT code 73521. Do not report procedure code 73521 with 50 modifier or report two unilateral CPT codes with LT & RT (73502-LT and 73502-RT). Such incorrectly coded procedures will not be paid by the payers.
Query answered for CPT code 73521 by CPT Assistant
Question:
How are the radiology unilateral and bilateral hip codes (73501-73523) reported when both hips are imaged in the same session?
Answer:
If a bilateral hip X-ray study is ordered and medically indicated, it is appropriate to report a bilateral hip X-ray CPT code (73521-73523). If both hips are imaged in the same session, the bilateral codes should be used and the number of images totaled to select the correct code. If both hips are imaged in the same session, it is inappropriate to report the unilateral hip codes.
I have an orthopedic surgeon who only wants one image taken of both hips in AP projection. What cpt code do I use? There is not a 1 view for bilateral hips…
When u do not have a code for one view, use two view Cpt code with a 52 modifier. Hope this will clear ur doubt.