13 No. WebThe following codes are included below for informational purposes only; this is not an all-inclusive list. A 65-year-old established Medicare patient presents for her annual well-woman exam. 52, reduced services: Under certain circumstances, a service or procedure is reduced or eliminated at the physicians discretion. In this context, annotation back-references refer to codes that contain: Code annotations containing back-references to, This is the American ICD-10-CM version of, Lung mass NOS found on diagnostic imaging of lung. Unable to process the form. The answer for second question is: Yes you can code 71020 for PA & Lateral Chest X-ray Thanks for the response. Other V codes commonly used for preventive services include V72.3 for reporting a gynecological examination performed in conjunction with a preventive service, V20.2 for a routine infant or child health check and V73.0-V82.9 for any special screening examinations (e.g., for colorectal cancer or lipid disorders). [2] Medical uses [ edit] Dedicated chest radiography room Diagnostic Radiology (Diagnostic Imaging) Procedures, Diagnostic Radiology (Diagnostic Imaging) Procedures of the Chest, Copyright 2023. Positive TB skin test 7. WebA chest PA Lateral X-ray is a radiograph of the thoracic cavity, ordered to examine the lungs, chest cavity and its divisions (such as the mediastinum cavity) as well as the great vessels of the heart. www.cms.gov/Medicare/Coding/NationalCorrectCodInitEd/downloads/modifier59.pdf, www.radiologytoday.net/archive/rt_110308p8.shtml. Generally, a chest X-ray follows this process:You will be asked to remove any clothing, jewelry, or other objects that may get in the way of the test.You will be given a gown to wear.You may be asked to lie down, sit, or stand. For a standing or sitting image, you will stand or sit in front of the X-ray plate. You will need to stay still during the X-ray. More items The 2023 edition of ICD-10-CM R91 became effective on October 1, PeekaPoo - Size, Character, Breeders, Mix, Color, Sale, Price, Southdown Sheep Disadvantages, Advantages, Characteristics, Price, Simangus Cattle Disadvantages, Advantages, Facts, Price, Murray Grey Cattle Pros and Cons, Facts, Price, Balancer Cattle Pros & Cons, Characteristics, Origin, Weight, Black Baldy Cattle Advantages, Disadvantages, Characteristics, Uses, Hampshire Sheep Pros and Cons, Temperament, Price. Selected Answer : a. Reference article, Radiopaedia.org (Accessed on 04 Mar 2023) https://doi.org/10.53347/rID-44853, {"containerId":"expandableQuestionsContainer","displayRelatedArticles":true,"displayNextQuestion":true,"displaySkipQuestion":true,"articleId":44853,"questionManager":null,"mcqUrl":"https://radiopaedia.org/articles/chest-pa-view-1/questions/301?lang=us"}. Therefore, the best initial test of the chest is a 2 view chest X-ray consisting of a PA and Lateral The PA view is frequently used to aid in diagnosing a range of acute and chronic conditions involving all organs of the thoracic cavity. What is a chest X-ray? Given the way the x-ray beam works, the heart appears smaller and with sharper borders on the PA view. Mode of transport of the patient, e.g. It should only be used if no other modifier more appropriately describes the relationships of the two or more procedure codes. Coding abdomen and chest x-rays is more straightforward than ever Anatomy views laterality and modifiers are important when coning radiological exams. endstream endobj 18 0 obj <>>> endobj 19 0 obj <>/ExtGState<>/Font<>/ProcSet[/PDF/Text]/XObject<>>>/Rotate 0/TrimBox[0.0 0.0 612.0 792.0]/Type/Page>> endobj 20 0 obj <>stream Insignificant problems may be addressed as part of a preventive visit. G@$7$'[G|L@- /> c CPT Codes: 71250, 71260, 71270 Chest CT CPT codes Code Description 71250 Chest CT without contrast 71260 Chest CT with contrast 71270 Chest CT without contrast, followed by re-imaging with contrast ICD-10 Diagnoses Codes You take the patients interval medical, family and social history and perform a complete review of systems. Usually, you will know the results of your X-ray within one to two days. When you ask about his current complaints, he mentions that he has had mild chest pain and a productive cough over the past week and that the pain is worse on deep inspiration. Otherwise, you are shortchanging yourself in terms of the work RVUs for these services, among other things. Healthcare providers can look at this image to diagnose and treat broken bones, heart conditions and The X-ray images also show the fluid accumulation in chest region i.e. hb``0```a Y Y83031p1`s`ehaP0A' ?J'hacf:\tAy/hB|cs#O`:i,pQv>&,V $! endstream endobj 425 0 obj <>/Filter/FlateDecode/Index[8 367]/Length 35/Size 375/Type/XRef/W[1 1 1]>>stream 0000010475 00000 n Remember to explain to your patient what you are about to do; that is ask them to take a breath in and hold it. Routine visits for patients of all ages are scheduled to promote wellness and disease prevention. Therefore, the E/M code reported for the problem-oriented service should be based on the additional work performed by the physician to evaluate that problem. The reason is that the patients chest (anterior) is against the x-ray film with the beam entering from posterior (P) to anterior (A) hence the term PA. We have been receiv Hi All, The 2023 edition of ICD-10-CM R07.9 became effective on October 1, 2022. 17 0 obj <> endobj A corresponding procedure code must accompany a Z code if a procedure is performed. You may need a chest X-ray if it is suspected that you have any of the following:Enlarged heart which can mean you have a congenital heart defect or cardiomyopathyFluid in the space between your lungs and your chest wall (pleural effusion)Pneumonia or another lung problemBallooning of the aorta or another great blood vessel (aneurysm)Broken boneHardening of a heart valve or aorta (calcification)Tumors or cancerMore items These modifiers yield a partial reimbursement. shoulders are rotated anteriorly to allow the scapulae to move laterally off the lung fields, and this can be achieved by either: hands placed on the posterior aspect of the hips,elbows partially flexed rolling anterior or, hands are placed around the image receptor in a hugging motion with a focus on the lateral movement of the scapulae, shoulders are depressed to move the clavicles below the lung apices, superiorly 5 cm above the shoulder joint to allow proper visualization of the upper airways, inferior to the inferior border of the 12, the chin should not be superimposing any structures, arms are not superimposed over lateral chest wall (this can mimic pleural thickening), minimal to no superimposition of the scapulae borders on the lung fields, a maximum of ten posterior ribs are visualized above the diaphragm, the ribs and thoracic cage are seen only faintly over the heart, clear vascular markings of the lungs should be visible. Modifiers 52 and 53, which are utilized less frequently, are to be used when a service is started and not performed to its full extent for any reason. Hemoptysis 4. WebOn the PA view, the cardiac borders are smaller and more defined. lR- kW/2fegefXjyG@,_'Q;^F ` vK,$ By Sivaraj Ramesh CPC CEMC CCS Ribs are long curved bones that are slightly twisted on a long axis. 0000007215 00000 n This may represent a different session or patient encounter, different procedure or surgery, different site or organ system, separate incision/excision, separate lesion, or separate injury (or area of injury in extensive injuries) not ordinarily encountered or performed on the same day by the same physician. within or around the lungs and the air which surrounds lungs. Medicare covers the full allowable amount for all reported services. WebRadiology CPT codes X-ray Neck Soft Tissue 70360 Clavicle Complete 73000 Chest (1/2 views) 71010, 71020 Infant Chest w/ Abdomen 74000, 71010 Ribs Unilateral 2 views 71100 Ribs Bilaterial 3 views 71110 Ribs Bilateral w/ Chest (min 4 views) 71111 Abdomen AP/Decub/Erect 74020 Abdomen AP (KUB) 74000 Pelvis (1-2 views) 72170 Image Quality (R.I.P) R - Rotation. For a better experience, please enable JavaScript in your browser before proceeding. 0000010700 00000 n The comprehensive history and examination performed during a preventive medicine encounter are not the same as the comprehensive history and exam that are required for certain problem-oriented E/M codes (99201-99350) and defined in Medicares Documentation Guidelines for Evaluation & Management Services. walking, chair or trolley Suggested number: Radiographer who has taken the chest x-ray - this may be kept confidential 4. JavaScript is disabled. 0000028897 00000 n Single Radiograph Effective Dose, mrem (mSv) Skull (PA or AP)1 3 (0.03) Skull (lateral) 1 1 (0.01) Chest (PA) 1 2 (0.02) Chest (lateral) 1 4 (0.04) Chest (PA and lateral) 2 6 (0.06) Thoracic spine (AP) 1 40 (0.4) Thoracic spine (lateral) 1 Railroad Medicare's Medical Review (MR) unit is conducting a service-specific review of chest X-ray CPT endstream endobj startxref 0 %%EOF 63 0 obj <>stream %%EOF WebAppt Reason CPT Code CPT Code XR Abdomen Flat & Decubitus (3 Views) 74021 (2 Views PA and Lat) 74019 XR Abdomen Flat & Upright & PA Chest 74019 71045 XR Abdomen-KUB (1 View) 74019 XR Acromioclavicular Jnt Uni or Bilateral 73050 XR Ankle 2 Views Uni or Bilateral 73600 XR Ankle 3 Views Uni or Bilateral 73610 XR Bone Age Study 0000001600 00000 n 77, repeat procedure, different physician: This modifier should be included with the CPT code for the same scenario involving modifier 76 but when a different physician performs the repeat procedure. Various problems can be diagnosed with chest x-ray like emphysema, cancer, pneumonia, collapsed lung, broken ribs and many other conditions related to heart and lungs. He performs this procedure to identify problems pertaining to the ribs. By Edwina Sprow, CPC A normal chest x-ray will consist of both posteroanterior (PA) and lateral films which are read together. Nonspecific abnormal findings disclosed at the time of these examinations are classified to categories, examinations related to pregnancy and reproduction (. hWmo6b"6m&mAX,ydNl'M;. Each chest x-ray is checked whether it is an AP or PA using RIS and PACS 2. 0000139851 00000 n but can someone please explain to me what i'm looking for in a radiology report for these two Hi, Background Chest CT scan and chest x-rays show characteristic radiographic findings in patients with COVID-19 pneumonia. Deciding which of these options to choose depends on the clinical circumstances and your medical judgment. Chest X-rays are quick, noninvasive tests. Combat the #1 denial reason - mismatched CPT-ICD-9 codes - with top Medicare carrier and private payer accepted diagnoses for the chosen CPT code. trailer <]/Prev 430015/XRefStm 1600>> startxref 0 %%EOF 426 0 obj <>stream You also perform a physical examination that includes a blood-pressure check and thyroid, breast, abdominal and pelvic examinations, and you obtain a Pap smear. WebChest X-ray, PA and lateral: USING DIAGNOSIS CODES EFFECTIVELY. Chest Chest 1 view 71045 Chest 2 views (PA & Lateral) 71046 Chest (front, lat, w/apical) 3 views 71047 Chest (PA lat & Obliques) 71047 or 71048 Chest complete 4 hb``c``f P#0p4 A1c, C9&1F1FYFN~C8O0*2q0[T=[MHMzu/6. 0000010361 00000 n ADVERTISEMENT: Supporters see fewer/no ads. Case 3: arms mimicking pleural thickening, see full revision history and disclosures, shoulder (modified transthoracic supine lateral), acromioclavicular joint (AP weight-bearing view), sternoclavicular joint (anterior oblique views), sternoclavicular joint (serendipity view), foot (weight-bearing medial oblique view), paranasal sinus and facial bone radiography, paranasal sinuses and facial bones (lateral view), transoral parietocanthal view (open mouth Waters view), temporomandibular joint (axiolateral oblique view), cervical spine (flexion and extension views), lumbar spine (flexion and extension views), systematic radiographic technical evaluation (mnemonic), foreign body ingestion series (pediatric), foreign body inhalation series (pediatric), pediatric chest (horizontal beam lateral view), neonatal abdominal radiograph (supine view), pediatric abdomen (lateral decubitus view), pediatric abdomen (supine cross-table lateral view), pediatric abdomen (prone cross-table lateral view), pediatric elbow (horizontal beam AP view), pediatric elbow (horizontal beam lateral view), pediatric forearm (horizontal beam lateral view), pediatric hip (abduction-internal rotation view), iodinated contrast-induced thyrotoxicosis, saline flush during contrast administration, CT angiography of the cerebral arteries (protocol), CT angiography of the circle of Willis (protocol), cardiac CT (prospective high-pitch acquisition), CT transcatheter aortic valve implantation planning (protocol), CT colonography reporting and data system, CT kidneys, ureters and bladder (protocol), CT angiography of the splanchnic vessels (protocol), esophageal/gastro-esophageal junction protocol, absent umbilical arterial end diastolic flow, reversal of umbilical arterial end diastolic flow, monochorionic monoamniotic twin pregnancy, benign and malignant characteristics of breast lesions at ultrasound, differential diagnosis of dilated ducts on breast imaging, musculoskeletal manifestations of rheumatoid arthritis, sonographic features of malignant lymph nodes, ultrasound classification of developmental dysplasia of the hip, ultrasound appearances of liver metastases, generalized increase in hepatic echogenicity, dynamic left ventricular outflow tract obstruction, focus assessed transthoracic echocardiography, arrhythmogenic right ventricular cardiomyopathy, ultrasound-guided biopsy of a peripheral soft tissue mass, ultrasound-guided intravenous cannulation, intensity-modulated radiation therapy (IMRT), stereotactic ablative radiotherapy (SBRT or SABR), sealed source radiation therapy (brachytherapy), selective internal radiation therapy (SIRT), preoperative pulmonary nodule localization, transjugular intrahepatic portosystemic shunt, percutaneous transhepatic cholangiography (PTC), transhepatic biliary drainage - percutaneous, percutaneous endoscopic gastrostomy (PEG), percutaneous nephrostomy salvage and tube exchange, transurethral resection of the prostate (TURP), long head of biceps tendon sheath injection, rotator cuff calcific tendinitis barbotage, subacromial (subdeltoid) bursal injection, spinal interventional procedures (general), transforaminal epidural steroid injection, intravenous cannulation (ultrasound-guided), inferomedial superolateral oblique projection, breast ultrasound features: benign vs malignant, patient is erect facing the upright image receptor, the superior aspect of the receptor is 5 cm above the shoulder joints, the chin is raised as to be out of the image field. registered for member area and forum access. An X-ray is an imaging test that uses small amounts of radiation to produce pictures of the organs, tissues, and bones of the body. Reimbursement claims with a date of service on or after October 1, 2015 require the use of ICD-10-CM codes. This chapter includes symptoms, signs, abnormal results of clinical or other investigative procedures, and ill-defined conditions regarding which no diagnosis classifiable elsewhere is recorded. WebPosition of part The left shoulder and hip should be elevated to rotate the thorax. It does include a comprehensive review of systems, a comprehensive or interval past, family and social history, and a comprehensive assessment/history of pertinent risk factors. @$kcg`4> X CPT Code 71275. Major chest trauma 3. Age-appropriate counseling and discussion of issues common to the age group are also included in the preventive medicine services. A poor-inspiratory PA radiograph can mimic pathology. I have a question which is confusing me. LOINC code: 42272-5: name: XR Chest PA and Lateral: status: ACTIVE: Fully-Specified Name: component: Views PA + lateral: property: Find = Finding: time: Pt = Point in time: To identify measures at a point in time. Jr RBJ, FACR BJMMDP, Osborn AG et-al. WebFor each CXR: 1. Copyright 2004 by the American Academy of Family Physicians. Structures that block radiation appear white, and structures that let radiation through appear black. 5. Normal anatomy and variants. WebAt Berger Health System [ 3] in Ohio, a one-view chest X-ray costs $203 and a two-view, $250. (See the examples of preventive services for Medicare patients and Medicares covered preventive services for a list of covered services.). WebCHEST. The study aims at describing the chest x-ray findings and temporal radiographic changes in COVID-19 patients. You make a diagnosis of acute bronchitis with chest pain and prescribe medication and bed rest along with instructions to stop smoking. WebLOINC 42272-5 XR Chest PA and Lateral LOINC Code 42272-5 XR Chest PA and Lateral Version 2.74 42272-5 XR Chest PA and Lateral Active Fully-Specified Name Component Views PA + lateral Property Find Time Pt System Chest Scale Doc Method XR Additional Names Short Name XR Chest PA+Lat Associated Observations A chest X-ray is an imaging test that uses X-rays to look at the structures and organs in your chest. In fact every radiologst should be an expert in chest film reading. Chest (PA view). Medicare does not provide reimbursement for CPTs comprehensive preventive medicine services codes described above, but because of the Balanced Budget Act of 1997, it does provide reimbursement for certain screening services provided in the absence of an illness, disease, sign or symptom, such as a screening pelvic and clinical breast exam. 0000032516 00000 n Is there anyone that may have any coding documentation on how to correctly bill for X-Ray of Ribs (71100) versus X-Ray of ribs with one chest (71101). WebImage projection: PA (posterior-anterior) or AP (anterior-posterior) or lateral Patient's position. This is the American ICD-10-CM version of, encounter for screening for respiratory tuberculosis (, Encounter for screening for active tuberculosis disease, Z codes represent reasons for encounters. You document both the problem-oriented and the preventive components of the encounter in detail. You would want to report 71100 and 71046, not 71101. {"url":"/signup-modal-props.json?lang=us"}, Murphy A, Er A, Al-Tweel A, et al. %PDF-1.5 % You should submit the appropriate preventive medicine counseling code for this visit and ICD-9 codes V65.3 and V65.41. Ok, so i know that NCCI edits bundle 71020 and 71101 with an allowed mod and if it's medically necessary. I posted this on the Interventional Radiology board yesterday but we're really anxious for an answer so I decided to post here also. Code History 2016 (effective 10/1/2015): New code (first year of non-draft ICD-10-PCS) 2017 (effective 10/1/2016): No hb```*V eaXjtGnhNI~! How to read chest x-raysIntroduction. Chest X-ray interpretation is one of the fundamental skills of every doctor. Emergency physicians are particularly exposed to various chest x-rays during a regular shift.Interpretation. The interpretation of a chest X-Ray should be approached systematically. References and Further Reading. Clinical Practise Of Emergency Medicine. The phase of respirationhas a profound effect on the appearance of several structures on the chest radiograph (see Case 2 for inspiration and expirationimages in the same patient). Modifier 59 is used to identify procedures/services that are not normally reported together, but are appropriate under the circumstances. Reporting both preventive and problem-oriented services on the same date can often lead to inconsistent results. IMG 3146. Where a radiology service is performed, who owns the equipment, and who is performing the interpretation all factor into when (and which) codes should be submitted with a modifier. endstream endobj startxref Figure 9.2 Chest x-ray, Lateral, Line drawing #FOAMed Medical Education Resources by LITFL is A person viewing it online may make one printout of the material and may use that printout only for his or her personal, non-commercial reference. WebTuberculosis creates cavities visible in x-rays like this one in the patient's right upper lobe. The chest x-ray is the most common radiological investigation in the emergency department 1. At Saint Elizabeth Regional Medical Center [ 4] in Nebraska, a chest X-ray costs $207 for a single, frontal view; $295 for two views, frontal and lateral; and $331 for special views such as lateral decubitus. Methods From March To ensure that youll receive at least some reimbursement, you can try reporting either the preventive medicine or the problem-oriented service, depending on which of the two services was the primary focus of the visit and required the most significant amount of physician time and work. Search across Medicare Manuals, Transmittals, and more. For example, the radiology code 71020 (two view chest, frontal and lateral) is considered a global CPT code, as it consists of the professional component and the technical component combined. Tracy You must log in or register to reply here. On average, rotation of 15-20 degrees is required. 0000091313 00000 n While there was a complete overhaul of the 2018 abdomen and chest x-ray codes, it certainly seems to have been for the better. 0000028261 00000 n WebThe technician goes into an adjacent room or behind a wall to run the machine. Specific preventive medicine services for a 25-year-old healthy female will be very different from those for a 55-year-old male and even a 55-year-old female, but the general components of a preventive medicine visit according to CPTs preventive medicine services codes (99381-99397) remain the same: A comprehensive history and physical examination. Radiology procedures are defined as global services and fall in the 7xxxx series of the CPT book. Suspected PE, Pneumonia, CHF, pleural effusion, pneumothorax 6. WebThe mean radiation dose to an adult from a chest radiograph is around 0.02 mSv (2 mrem) for a front view (PA, or posteroanterior) and 0.08 mSv (8 mrem) for a side view (LL, or latero-lateral). 0000091274 00000 n Vol. 0000008530 00000 n 71020 , 74150-26 Correct Answer : a. Edwina Sprow, CPC, a coding specialist for North Scottsdale Family Medicine Associates in Arizona and a member of AAPC, has more than 25 years of experience in the healthcare industry. Screening is the testing for disease or disease precursors in asymptomatic individuals so that early detection and treatment can be provided for those who test positive for the disease. The clarification helps and I'm making notes in my book as we speak!! WebWhat is the CPT code for posteroanterior and lateral chest x-ray? Modifier 50 is typically used more often than modifier LT/RT; however, payers generally dictate how these get used. The history associated with preventive medicine services is not problem-oriented and does not involve a chief complaint or history of present illness. WebRadiology CPT codes X-ray Neck Soft Tissue 70360 Clavicle Complete 73000 Chest (1/2 views) 71010, 71020 Infant Chest w/ Abdomen 74000, 71010 Ribs Unilateral 2 views 71100 Ribs Bilaterial 3 views 71110 Ribs Bilateral w/ Chest (min 4 views) 71111 Abdomen AP/Decub/Erect 74020 Abdomen AP (KUB) 74000 Pelvis (1-2 views) 72170 As such, it is important to research all potential modifiers available prior to selecting modifier 59. If this is the case, two line items will be reported: one with modifier LT and one with modifier RT. 0000127406 00000 n Saunders. We have been billing 71100 - rib unilateral 2 views & 71046 - 2 views of the chest. Additionally, it serves as the most sensitive plain radiograph for the detection of free intraperitoneal gas or pneumoperitoneumin patients with acute abdominal pain. Practically all categories in the chapter could be designated 'not otherwise specified', 'unknown etiology' or 'transient'. 0000019135 00000 n encounter for diagnostic examination-code to sign or symptom. This type of counseling varies according to the age of the patient, but it generally includes such issues as diet, exercise, smoking cessation and sexual practices. 2. 0000053582 00000 n I am a little confused when it comes to the chest rib xray codes. abnormal findings on antenatal screening of mother (, certain conditions originating in the perinatal period (, signs and symptoms classified in the body system chapters, nonspecific abnormal findings on diagnostic imaging by computerized axial tomography [CAT scan], nonspecific abnormal findings on diagnostic imaging by magnetic resonance imaging [MRI][NMR], nonspecific abnormal findings on diagnostic imaging by positron emission tomography [PET scan], nonspecific abnormal findings on diagnostic imaging by thermography, nonspecific abnormal findings on diagnostic imaging by ultrasound [echogram], nonspecific abnormal findings on diagnostic imaging by X-ray examination, diagnostic abnormal findings classified elsewhere - see Alphabetical Index, Abnormal findings on diagnostic imaging of lung, Magnetic resonance imaging of chest abnormal, pulmonary eosinophilia due to aspergillosis (, pulmonary eosinophilia due to specified parasitic infection (, pulmonary eosinophilia due to systemic connective tissue disorders (, Solitary pulmonary nodule, subsegmental branch of the bronchial tree. Web99213, 70460. Or you could have the patient return for another visit to address the management of the problem or the preventive care. We have been receiving denials stating we shou [b]Re: chest/ rib xrays[/b] Chest x-ray can be used in diagnosis and follow up in patients with COVID-19 pneumonia. An insignificant or trivial problem or abnormality that does not require performance of these key components should not be reported separately from the preventive medicine service. It's always nice to know you're not totally off track when you're trying to figure out something new. Look in the CPT Index for X-ray/Chest directing you to 71010-71035, and CT Scan/without Contrast/Abdomen directing you to 74150, 74176, and 74178. Note that the work associated with performing the history, examination and medical decision making for the problem-oriented E/M service will likely overlap those performed as part of the comprehensive preventive service to a certain extent. 0000130649 00000 n Please Note: You can also scroll through stacks with your mouse wheel or the keyboard arrow keys. The gonads should be shielded. WebThe 2 view chest x-ray would be reported with code 71046, and the abdomen x-ray would be reported with code 74019 or 74021 depending on the number of views. WebChest X-rays use a small dose of radiation to create a black-and-white image. Selected Answer : b. You should submit the following codes (and related charges) to Medicare: G0101 for the pelvic exam and clinical breast check, Q0091 for the collection of the Pap smear specimen and V76.2, Special screening for malignant neoplasms; cervix; and the following codes (and related charges) to the patient: 99397, Periodic comprehensive preventive medicine established patient, 65 years and over, and V72.3, Special investigations and examinations; gynecological examination. The total amount billed and received for this visit should equal your usual charge for an annual exam of $100. It has been a few years since I worked in a Radiology department but I did, Ann, thanks so much for the summary, it's very helpful! The most common modifiers in radiology billing are 26, TC, 76, 77, 50, LT, RT, and 59. Appropriate ICD-9 codes should be reported on every claim to provide an accurate reflection of the reason a service was provided. Weblateral , and sunrise none kub kub n/a 74018 kidneys, ureters, and bladder none lumbar spine 4-5 views lumbar spine or lumbosacral lsp 72110 ap, both obliques, lateral, and l5-s1 spot system: Chest: scale (For information about other Medicare-covered screening services, go to http://www.medicare.gov/health/overview.asp. (See the example of a preventive E/M visit with a problem-oriented service, and for more on ICD-9 codes, see Using diagnostic codes effectively.). 76, repeat procedure, same physician: When a procedure or service must be performed again on the same date of service by the same physician (regardless of the outcome), this modifier should be included with the CPT code on the CMS-1500 form.