COMPARISON XRAYS ICD10

RebeccaMRebeccaM
in Orthopedics
We are seeing a patient for his right wrist. Doctor orders a "left" wrist xray for comparison to determine if the right was ulnar positive/negative or is he had bilateral changes. What diagnosis should I use for the "left" comparison xray? I've been given right extensor tendonitis(M65.831) and rt wrist pain(M25.531). Thank you,

Comments

  • scalley123@aol.comscalley123@aol.com
    edited May 2017
    Chapter 9 of the NCCI guidelines updated their policy regarding comparison
    views and also post-reduction views stating that the only thing you could
    bill would be the technical component of the imaging CPT code.

    As far as ICD10 it would fall under condition not found or observation
    normal findings or suspected condition not found

    Margie Scalley Vaught, CPC, COC, CPC-I, CCS-P, MCS-P, ACS-EM, ACS-OR
    Auditing, Coding, Documentation and Compliance Consulting
    Healthcare Consultant_ scalley123@aol.com_ (mailto:scalley123@aol.com)
    cell 360-880-8304
    fax 413-674-7668_www.margievaught.com_ (http://www.margievaught.com/)
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  • RebeccaMRebeccaM
    edited May 2017
    So, you think this applies when just ordering a comparison view in the office simply to compare the right side with the left side. No procedure was done prior to the visit.
    Thank you,
  • scalley123@aol.comscalley123@aol.com
    edited May 2017
    Here is what is says:
    "3. When a comparative imaging study is performed to assess potential
    complications or completeness of a procedure(e.g., post-reduction,
    post-intubation, post-catheter placement, etc.), the professional component of the CPT
    code for the post-procedure imaging study is not separately payable and
    should not be reported. The technical component of the CPT code for the
    post-procedure imaging study may be reported."

    Margie Scalley Vaught, CPC, COC, CPC-I, CCS-P, MCS-P, ACS-EM, ACS-OR
    Auditing, Coding, Documentation and Compliance Consulting
    Healthcare Consultant_ scalley123@aol.com_ (mailto:scalley123@aol.com)
    cell 360-880-8304
    fax 413-674-7668_www.margievaught.com_ (http://www.margievaught.com/)
    facebook: margie s vaught
    for workshops and audio_ http://www.margievaught.com/calendar/index.cfm_
    (http://www.margievaught.com/calendar/index.cfm)
    Want to receive a monthly newsletter - signup on_ margievaught.com_
    (http://margievaught.com/)
    Check the calendar for audios/webinars and live presentations already
    scheduled - 2017 
  • dravenscroft@lhoa.comdravenscroft@lhoa.com
    edited May 2017
    So Margie, if the surgeon does a ORIF of a distal radius and takes x-rays in the OR to make sure everything is aligned and no screws are into the joint --- that means that only the TC portion of the x-ray can be billed??
  • scalley123@aol.comscalley123@aol.com
    edited May 2017
    That could be a different situation since they are not using their own
    equipment - and CPT and AAOS have both stated that if during an operative
    procedure they use imaging, make hard copies and give an official
    interpretation they could then report the appropriate imaging code such as 73110-26
    for the interpretation. This usually is only the imaging taken during that
    encounter.
    Whereas in an office setting we take an xray and find that they have a
    fracture - they reduce and we take another one to make sure it is reduced,
    that is what the CCI guidelines are talking about not intraoperative imaging.

    Margie Scalley Vaught, CPC, COC, CPC-I, CCS-P, MCS-P, ACS-EM, ACS-OR
    Auditing, Coding, Documentation and Compliance Consulting
    Healthcare Consultant_ scalley123@aol.com_ (mailto:scalley123@aol.com)
    cell 360-880-8304
    fax 413-674-7668_www.margievaught.com_ (http://www.margievaught.com/)
    facebook: margie s vaught
    for workshops and audio_ http://www.margievaught.com/calendar/index.cfm_
    (http://www.margievaught.com/calendar/index.cfm)
    Want to receive a monthly newsletter - signup on_ margievaught.com_
    (http://margievaught.com/)
    Check the calendar for audios/webinars and live presentations already
    scheduled - 2017 
  • scooperscooper
    What if comparison xrays are being performed NOT following a procedure. Example: Patient is seen for the first time and following xray of RT Ankle, is found to have chronic fracture. For comparison, the doctor returns them to the xray room to have an xray of the LT Ankle. Should the comparison LT ankle be billed with a TC only? Billed without any modifiers or billed with a -52?
  • rdennisrdennis
    scooper, ever hear anything on this specific question?  I too want confirmation as I have the same situation in one of our clinics.
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