Chest X-rays are an extremely common diagnostic imaging examination in the United States. Although it is a simple and common procedure, healthcare professionals still file inaccurate claims for X-ray billing.
This is why we are here today! To help you file accurate claims for CPT code 70146 (used for a chest X-ray). To find out what the essential details are for billing this code, keep reading!
CPT Code 71046 – Description
CPT code 71046 refers to a diagnostic chest X-ray with two views. During this procedure, the healthcare provider obtains at least two radiological views of the chest, including posteroanterior (PA view) and one from the side (lateral view). It is a quick and painless imaging procedure that offers a comprehensive view of the structures within the chest.
The X-ray results help diagnose and monitor chest abnormalities and guide treatment decisions.
Appropriate Use Cases for CPT Code 71046
The following are a few scenarios that perfectly describe the application of CPT code 71046 in a medical setting.
Pneumonia
Suppose a 42-year-old female with severe congestion and a persistent fever (102 degrees) for three days visits a physician. She further adds that she is experiencing fatigue and chest discomfort on the right side. When the physician examines her, he notices crackles in the right lower lung field and decreased breath sounds. He suspects pneumonia and orders a chest X-ray with frontal and lateral views for diagnosis.
In this case, the physician may bill his interpretation and report with CPT code 71046 and modifier 26 because the X-ray was taken from two views.
Tuberculosis Screening
Suppose a 50-year-old patient who was previously treated for tuberculosis (TB). He again presents to the physician’s office with a severe cough combined with red mucus, and he has lost significant weight within a month. The physician orders a chest X-ray with two views to check the current severity of the TB.
The radiologist performing the two-view chest X-ray will bill CPT code 71046 because both views were medically necessary for a comprehensive evaluation.
Preoperative Clearance for Surgery
For our last scenario, consider a 68-year-old patient with chronic obstructive pulmonary disease (COPD). He is scheduled for an elective abdominal surgery, but due to an underlying lung condition and smoking history, the anesthesiologist requests a preoperative chest X-ray to assess lung status and rule out active infection or fluid accumulation.
A two-view chest radiograph is obtained to evaluate heart size, lung fields, and diaphragm positioning. CPT code 71046 is the appropriate code to bill the X-ray.
Modifiers to Append with CPT Code 71046
The following are some modifiers that are usually appended to CPT code 71046 based on the situation.
Modifier 26
Modifier 26 indicates the professional component of a medical service. It is used to bill the physician’s interpretation and report. Therefore, append modifier 26 to code 71046 if the physician only interpreted and reported the X-ray results.
Modifier TC
On the other hand, modifier TC is used when the facility is billing only for the technical component of the radiology procedure, such as equipment, supplies, and the technician’s services.
Modifier 59
If the chest X-ray was another distinct service performed on the same patient on the same day, you will bill it with the modifier 59 to unbundle the services, bypass NCCI edits, and collect separate payments for each.
Reimbursement Guidelines for CPT Code 71046
Finally, here are the essential guidelines that you cannot afford to leave out if you want to bill CPT code 71046 accurately.
Use 71046 Appropriately
First things first, you must understand the description of CPT code 71046. If you are not fully aware of this, you will keep making errors in your claims.
This code is used to bill X-ray services for diagnostic purposes only. If it is a routine X-ray, you must use another code to bill that service. Furthermore, the code refers to chest X-rays taken from two separate views. You cannot bill it if the images were taken from a single side or more than two sides. There are separate billing codes for such scenarios. For instance,
- 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
Maintain Proper Documentation
The acceptance of your claims highly depends upon the completeness of your paperwork. The more detailed and comprehensive your paperwork is, the higher the chances of getting your claims accepted at first go. But some essential details must be mentioned regarding the claims of CPT code 71046.
You must establish the medical necessity of the procedure through your documents, explaining why these services were necessary. For this, you must provide a relevant history of the patient, a specific reason for the two-sided X-ray, and explain how the results will influence the patient’s plan of care. Furthermore, these documents must be duly signed by the authorized person.
In case of insufficient documentation or a lack of medical necessity proofs, the payer may deny your request for reimbursement.
Final Thoughts
We have covered almost all the essential details of CPT code 71046. It is a radiology billing code used to bill a diagnostic chest X-ray taken from two sides. The clinical indications for a two-view chest X-ray may include pneumonia, tuberculosis, or screening for any other infection before surgery. You may separately bill the professional and technical components of this code with modifiers 26 and TC, respectively. Lastly, be very vigilant about the supporting documentation.
Despite these guidelines, if you are still not confident about the billing of CPT code 71046, you can acquire specialized radiology billing services from NeuraBill. They have proven themselves in the field of medical billing with a 96% collection rate.
