How to Code Changes in X-Rays

Medical coders and biller have the challenging responsibility for turning services rendered into accurate and effective billing, which results in reimbursement. One of the most critical parts of that process is selecting the correct American Medical Association developed CPT code for each service, as Medicare, Medicaid and private insurers require accurate coding in order to process payments. From time to time, every medical coder faces a difficult decision on which CPT code to select. With changes in X-rays, it's much simpler than it might appear, as changes are really just a repetition or follow-up of the initial procedure.

Instructions

• 1

  Identify the correct X-ray type. Each X-ray has a different CPT code and the right choice depends on the part of the body and the technique used. For example a maxiofacial X-ray is a different code set than a foot X-ray.

• 2

  Confirm the procedure performed with the radiologist who performed the X-ray or physician who ordered it to be sure you understand the service rendered.

• 3

  Look-up the CPT code or codes using either your medical billing software, if you work electronically or using your ICD-9 code book if you work manually. Sometimes, in situations that call for interpretation, it can help to use the book to check the software's accuracy.

• 4

  Bill the initial X-ray using the code or codes you have identified. For example, many of the pediatric X-ray codes are found in the 77000 series of CPT codes and many chest X-rays are found in the 71000 series. If you have any doubts about the code you're using, check with other professionals or call the insurer you are billing for their interpretation.

• 5

  Code the second X-ray that reflects changes with the same CPT codes as the first set. The results of the procedure -- the change -- are not consequential to the billing. The service rendered was the same. The coding for the examination or consultation with the physicians will be different because the changed X-rays are likely to come from a follow-up visit which received different billing than an initial visit or emergency.