Various Imaging Views in Medical Billing

Various Imaging Views in Medical Billing

For imaging, medical billing should be done for views as opposed to film. Different payers require different methods of coding. There are many different ways to perform medical billing for a bilateral wrist x-ray with two views and a bilateral hand x-ray with two views.

If a physician orders two views of both the wrist and a hand, it can get confusing when one film captures both the wrist and hand. You are able to do medical billing for both views. For the most part, payers accept the medical billing code 73100 (Radiological examination, wrist; two views) two times and 73120 (Radiological examination, hand; two views) two times. To show why medical billing is used twice you will want to append with a modifier.

There are several ways to do medical billing for this service. You could use the medical billing code 73100 and use modifier 50 (Bilateral procedure). Another option is to simply bill 73100 with two units. Appending the medical billing code with sides is another option. There are two other medical billing modifiers that could be used with 73100. These are modifier 59 (Distinct procedural service) and modifier 76 (repeat procedure by same physician).

In this instance you can see that you may get more medical billing reimbursement than normal. However, there are instances where you will spend more money . For example, if you have a large patient you may need to capture several different films just to get one single view. In this instance you will only be able to do medical billing for one view. These two medical billing rules even each other out in the end.

This image example goes to show that there is no specific way to code multiple views. There are several different ways, so you may want to check with your payer as to which method they prefer. If your medical billing is agreeable, you will get more reimbursement.

View all Articles by: Melissa Clark, CCS-P