71046 CPT Code

71046 CPT Code (2022) Description, Guidelines, Reimbursement, Modifiers & Example

71046 CPT code bills for the service when the Physician performs the radiologic examination of the chest X-ray with two views.

71046 CPT Code Description

The following are reasons why the Physician performs Chest X-Ray:

To determine the change in size and shape of the heart

To identify the disformity of lungs, such as cancer, emphysema, cystic fibrosis, infections, etc.

To determine the tib fractures

To confirm the placement or position of a pacemaker, defibrillator, or catheter

To detect the presence of calcium in the heart and blood vessels.

The Physician performs radiologic imaging of the chest, which transfers electromagnetic wave radiation through the patient’s body. These waves generate a scan on X-ray film or a digital sensor. 

The Physician may take a broad series of chest images to detect disformity. These images show white bones on x-ray as radiation cannot emit through the bones. The muscles or other tissue may appear black or gray because some waves can pass through.

The Physician may need other studies and x-ray to determine the root cause of the problem, such as MRI, Ultrasound, and CT (computed tomography) scans.

cpt 71046

71046 CPT code bills for the service when the Physician performs the radiologic examination of the chest X-ray with two views.

71046 CPT Code Billing Guidelines

Documentation should support the medical necessity of service. It reflects that service is medically necessary and appropriate. 

If the Physician performs one view of the chest X-ray, it is appropriate to report with CPT 71045 instead of 71046 CPT code.

If the Physician performs three views of the chest X-ray, it is appropriate to report with CPT code 71046 instead of CPT 71047.

If the Physician performs four or more views of the chest X-ray, it is appropriate to report with CPT 71047 instead of CPT 71046.

If the Physician provides portable x-ray equipment and personnel transportation, It is appropriate to report services with R0070 and R0075.

If the Physician performs acute abdomen series, including a single view chest x-ray, it is appropriate to report with CPT code 74022. Check the payer guidelines if it is covered or not.

If Evaluation and management service(99202-9999) performs in addition to the chest-Xray, It is appropriate to report CPT code 71046 separately. 

If the Physician performs computer-aided detection (CAD) in addition to CPT code 71046, It is an appropriate report with 0174T. In contrast, If CAD performs remotely by the Physician, it is a relevant report with 0175T.

71046 CPT Code Modifiers

The following are the list modifiers when 71046 CPT code bills:  

22, 23, 26, 50, 52, 53, 58, 59, 76, 77, 78, 79, 99, AI, AQ, AR, CC, CR, ET, EY, FX, FY, GA, GC, GK, GR, GU, GY, GZ, KX, PT, Q5, Q6, QJ, SG, TC, XR, XP, XU, XS, LT, RT

The most frequent bill modifiers are 26, TC, 77, 76, 59, or X {E, P, S, U} with CPT code 71046.    

Modifier 26 bills to indicate the professional component of services when attached with 71046. It shows that the Physician work as an employee in a hospital and facility, not owning the equipment.  

Modifier TC applicable with 71046 CPT code indicates the Technical component or machinery used in service. It usually bills with Hospital and facility claims.  

CPT 71046 bills globally when physician-owned the office and equipment. Service bills without TC and 26 modifiers. 

 Modifier 76 is applicable with CPT 71046 when a similar service performs by the Same Physician on the same day.   

Modifier 77 is applicable with CPT code 71046 when a similar service performs by a different Physician on the same service date. 

Modifier 59 is applicable with 71046 CPT code when a Distinct service performs by the Physician and bundled with another procedure on the same date.   

Modifier X {E, P, S, U} is applicable instead of Modifier 59 with 71046 when service bills to medicare insurance. It divides the modifier into four parts for further specification of the procedure. 

If physicians believe that Medicare will deny such service, reporting with a GA  modifier is appropriate. The beneficiary must sign an Advance Beneficiary Notification (ABN), and CPT 71046 must apply the GA modifier to that service. 

Modifier 52 is applicable when the Physician cannot complete the procedure due to unavoidable circumstances.

71046 CPT Code Reimbursement

A maximum of two units can be a bill on the same service date of CPT code 71046. In contrast, the Three unit allows when documentation supports the medical necessity of the service.  

In OPPS global, the cost and RUVS of CPT 71046 with modifier 26 are $11.49 and 0.33213. The cost and RUVS of CPT 71046 with modifier 26 are $11.49 and 0.33213 when performed in the facility. In contrast, the reimbursement and RUVS of 71046 with modifier 26 are $11.49 and 0.33213 when completed non-facility.

The cost and RUVS of CPT code 71046 with modifier TC are $27.91and 0.80657 when performed in the facility. In contrast, the reimbursement and RUVS of CPT 71046 with modifier TC are $27.91and 0.80657 when performed in the non-facility. In OPPS global, the cost and RUVS of CPT 71046 with modifier TC are $96.75 and 2.78396.

In OPPS global, the cost and RUVS of 71046 CPT code with a global modifier are $107.84 and 3.11609. The cost and RUVS of CPT 71046 with global billing are $39.41 and 1.13870 when performed in the facility. In contrast, the reimbursement and RUVS of 71046 with global billing are $39.41 and 1.13870 when furnished in the non-facility. 

Procedures 71045–71046 have both technical and professional components. To report only the professional feature, append modifier 26. To bill only the technical part, append modifier TC. Submit without a modifier to bill the complete procedure (i.e., professional and technical components).

71046 CPT Code Examples

The following are the examples when CPT code 71046 bills:

Example 1

A 38-year-old male presents to ED with a chief complaint of dizziness. The patient reports vertigo began one day ago. Vertigo began while at home when he stood up. 

The patient describes the course of vertigo as abrupt, and The dizziness is currently 6/10. Vertigo worsened by standing, head movement, and movement. The vertigo is not worsened by breathing or lying supine. 

Anti-vertigo meds alleviate vertigo. Vertigo is associated with nausea, vomiting, and gait instability. Vertigo is not associated with a vision change. 

The patient is morbidly obese ha a higher risk of heart disease. The Physician ordered multiple diagnostic tests ECG, CMP, CBC, CT, MRI, and X-ray of the head, chest, and spine.

Diagnostic studies show that patient had an irregular heartbeat and suggested cardioversion.

Example 2

A 30-year-old female with no PMH is coming in for intermittent episodes of chest pain exacerbated by left-arm movement but is non-exertional. 

Given the positional nature of chest pain, I suspect a musculoskeletal cause. Differential includes, but is not limited to MSK-related pain/costochondritis/ ACS Pt is very well appearing with routine physical exam and vitals. She is not having any pain right now. 

The patient was not getting better by medication. Physicians ordered a CT and X-ray of the chest and EKG to confirm that the heart was functioning correctly. 

Diagnostic studies show that patient had an irregular heartbeat and suggested cardioversion.

Example 3

Forty-six-year-old female with PMH of hypertension and a family history of heart disease heart murmur, LBBB dx 1 year ago, migraines, tested positive for COVID 1 month ago. 

Since yesterday afternoon, she has presented to ED c/o constant lip-tingling, lightheadedness, and left-sided chest discomfort. She woke morning with the same symptoms, and she also developed left upper extremity tingling and bilateral hand tingling. The patient did not get vaccinated for COVID. 

The patient Denies headache, shortness of breath, back pain, abdominal pain, nausea, vomiting, diarrhea, changes in vision, urinary complaints, or any other symptoms. 

The patient has a family history of heart diseases—the physician plan to do labs, EKG, X-ray, CT, and MRI of the chest.

Diagnostic studies show that patient had an irregular heartbeat and suggested a Holter monitor for 24 hours.

Example 4

A 27-year-old male with PMH Systolic/Diastolic CHF (EF <15% 7/23/21, s/p AICD), COVID x2, s/p TAVR, CAD, CKD, PAD, hypothyroidism for shortness of breath. He has developed progressively worsening shortness of breath for four days. 

He noticed worsening SOB laying on his right side and with exertion. He takes his vitals daily and weighs himself daily. 

He typically weighs 171lbs but has seen a 3.5lb increase in his weight to 174.5lbs over this past week, which prompted him to take one dose of alprazolam 30mg. He noticed a minimal improvement in his symptoms with the alprazolam. 

When he has episodes of coughing with phlegm, he notices a substernal discomfort. The discomfort is not alleviated with rest and not exacerbated with exertion. He has also noticed increasing yellow phlegm production, cough, nasal congestion, and rhinorrhea. 

The Physician has respiratory problems along with Heart issues. Diagnostic studies show that patient had an irregular heartbeat and suggested cardioversion. The Physician ordered an X-ray of the chest, EKG, Labs, CT, and MRI to diagnose for further treatment.

Example 5

A 39-year-old female presented office for dizziness, weakness, and tingling in the upper extremity. The patient denies any abdominal pain, diarrhea, vomiting, or headache in the system review. 

Physical exam revealed that the patient had an irregular heartbeat, shortness of breath, and fluid accumulation in the upper extremity, more likely edema. A physical exam strongly suggests ruling out heart-related diseases. The Physician decides to do an X-ray, ECG/EKG, CTA, and MRA of the chest. 

Diagnostic studies show that patient had an irregular heartbeat and suggested cardioversion. EKG revealed that the patient is tachycardic. The Physician has consulted with the cardiologist for further treatment of the patient.

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