Procedure Code

[Sparky]

I have an exam question that I have two possible answers.....

Which code is appropriate for a radiologist's report on a 23-year old patient who had an X-ray of the left and right forearms?

Choices: A. 73090-50 B. 73090-LT, 73090-RT
C. 73221 D. 73090, 73090-59

I am choosing "B", I researched and read that a lot of payers don't recognize/accept this; but would accept (73090-50). Am I incorrect on my answer?? Thanking you in advance.

 

[Carolyn Heath]

I would choose A or B. Either one looks fine to me.

 

[Sparky]

Thank you so much Carolyn.

 

[Carolyn Heath]

You are welcome.

 

[Laureen]

It does depend on the payer. Modifier 50 usually results in a mathmatical formula applied where the fee gets multiplied by 150%.

For procedures they usually pay 100% of the 1st procedure and 50% of the subsequent so they treat one side as first procedure and the other side as a subsequent procedure. This makes sense for procedures like surgery but it doesn't for radiology. Each xray should be paid independently because there is no shared component to the work. That is why you will usually see radiology coding use RT and LT not 50.

That being said some payers may tell you other wise.

Happy coding!

 

[Carolyn Heath]

Thanks, Laureen, for backing me up on this one.

 

[Sparky]

Laureen and Carolyn, thank you both, I now have a better understanding.

 

[Carolyn Heath]

Sparky, you are most welcome.