71046 CPT Code (2023) | Description, Guidelines, Reimbursement, Modifiers & Example

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

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 an 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-rays to determine the root cause of the problem, such as MRI, Ultrasound, and CT (computed tomography) scans.

The official description of CPT code 71046 is: “Radiologic examination, chest; 2 views.”

cpt 71046

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, Reporting services with R0070 and R0075 is appropriate.

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 to see if it is covered or not.

If the 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.

Reimbursement

A maximum of two units can be a bill on the same service date of CPT code 71046. In contrast, the three units allow 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 $ 27.91 and 0.80657 when performed in the facility. In contrast, the reimbursement and RUVS of CPT 71046 with modifier TC are $ 27.91 and 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).

Billing Examples

The examples below are cases when the 71046 CPT code may be billed.

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 is 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 and has 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 the patient had an irregular heartbeat and suggested cardioversion.

Example 2

A 30-year-old female with no PMH is coming in for intermittent 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 with 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 the 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 one 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 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 chest MRI.

Diagnostic studies show that the 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 lying on his right side and with exertion. He takes his vitals daily and weighs himself daily. 

He typically weighs 171 lbs but has seen a 3.5lb increase to 174.5 lbs over this past week, prompting 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 the 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. 

A 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 the 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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