Streamlining chest x-ray CPTs in 2018

Nov. 15, 2017 / By Allison Morgan, MS, CPC

Chest x-ray imaging codes are one of the most highly utilized codes seen in the coding and medical industry, so it was a pleasant surprise to see these codes getting some TLC with the 2018 CPT updates. The new changes allow chest x-rays to finally catch up to a number of their fellow x-ray codes when it comes to simplifying the number of views being reported.

Historically, chest x-rays were reported with nine different codes to ultimately reflect one to four views being captured. Doing the math, nine codes for what are often relatively straightforward images was often seen as “muddying the waters.” These nine codes have now been trimmed down to four codes based solely on number of views:

• 71045 Radiologic examination, chest; single view
• 71046 Radiologic examination, chest; 2 views
• 71047 Radiologic examination, chest; 3 views
• 71048 Radiologic examination, chest; 4 or more views

Below is a breakdown of old codes vs. new code utilization:

While the streamlining of the codes comes as a sigh of relief to many coders, this new set of codes also highlights the importance of documenting the types and/or number of views for these services. Taking for instance the new three view chest x-ray code (71047), making sure all three views are documented can be the difference between a two view and three view code, and ultimately higher reimbursement.  And while chest x-rays have often been seen as lower reimbursement services, their high utilization will still make the impact of level selection felt.

To support compliant documentation and coding, documenting the specific number of views needs to be addressed in various facets of the report. This includes views ordered versus views performed, as well as what is documented in the exam title versus views documented in the technique. Given the heavy integration of HIS and RIS templating, this may also impact exam title options such as a 1-2 view option. Be sure to review and prepare for these aspects with your practice, coding and revenue cycle teams as these changes approach.

Allison Morgan is a clinical development analyst at 3M Health Information Systems.

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