How To Use CPT Code 73080

CPT 73080 is a radiologic examination code for the elbow, requiring a minimum of three views; this article will cover its description, procedure, qualifying circumstances, usage, documentation requirements, billing guidelines, historical information, similar codes, and examples.

1. What is CPT 73080?

CPT 73080 is a medical billing code used to describe a specific type of radiologic examination for the elbow. This code is utilized by medical professionals to accurately document and bill for the services provided during the examination. Understanding the proper use of CPT 73080 is essential for medical coders and billers to ensure accurate and timely reimbursement for the services rendered.

2. 73080 CPT code description

The official description of CPT code 73080 is: “Radiologic examination, elbow; complete, minimum of 3 views.”

3. Procedure

1. The patient is positioned comfortably, with the elbow in a stable position.
2. The radiologic technician selects the appropriate views and positions for the examination, which may include AP, lateral, frontal, transverse, cross table, standing, swimmer, etc.
3. A minimum of three views of the elbow are taken using X-ray equipment.
4. The images are reviewed by a radiologist or other qualified healthcare professional to assess for injury, fracture, arthritis, bone spurs, tumors, or congenital abnormalities.
5. Additional views or imaging may be performed if necessary, based on the findings of the initial examination.

4. Qualifying circumstances

Patients who are eligible to receive CPT code 73080 services include those presenting with symptoms or conditions that warrant a radiologic examination of the elbow. These may include, but are not limited to, pain, swelling, limited range of motion, suspected fracture, dislocation, arthritis, bone spurs, tumors, or congenital abnormalities. A healthcare provider must determine the medical necessity for the examination and provide a referral or order for the radiologic examination.

5. When to use CPT code 73080

It is appropriate to bill the 73080 CPT code when a complete radiologic examination of the elbow, with a minimum of three views, is performed to diagnose or assess a patient’s condition. This code should be used when the examination is medically necessary and ordered by a qualified healthcare provider. It is important to ensure that the services provided align with the specific requirements of CPT code 73080 to avoid billing errors or denials.

6. Documentation requirements

To support a claim for CPT 73080, the following information should be documented in the patient’s medical record:

• Referral or order for the radiologic examination from a qualified healthcare provider
• Indication or reason for the examination (e.g., pain, swelling, suspected fracture, etc.)
• Details of the procedure, including the number of views taken and positions used
• Findings and interpretation of the examination by a radiologist or other qualified healthcare professional
• Any additional imaging or follow-up care recommended based on the examination results

7. Billing guidelines

When billing for CPT code 73080, it is important to follow established guidelines and rules to ensure accurate reimbursement. Some tips for billing this code include:

• Appending modifier LT (left side) or RT (right side) to the code, depending on payer preference
• Using modifier 76 if a prereduction X-ray of the elbow is performed and the reduction is confirmed by repeating the X-ray
• Ensuring that all documentation requirements are met and properly recorded in the patient’s medical record

8. Historical information

CPT 73080 was added to the Current Procedural Terminology system on January 1, 1990. The code was changed on January 1, 2009, with the previous descriptor being “Radiologic examination, elbow; complete, minimum of three views.”

9. Similar codes to CPT 73080

There are several other CPT codes related to radiologic examinations of the elbow, which differ from CPT 73080 in various ways:

1. CPT 73070: This code is for a radiologic examination of the elbow with two views, rather than the minimum of three views required for CPT 73080.
2. CPT 73085: This code is used for a radiologic examination of the elbow with stress views, which are not included in CPT 73080.
3. CPT 73090: This code is for a radiologic examination of the forearm, rather than the elbow.
4. CPT 73092: This code is for a radiologic examination of the humerus, which is not part of the elbow examination in CPT 73080.
5. CPT 73100: This code is for a radiologic examination of the wrist, which is a different anatomical area than the elbow covered by CPT 73080.

10. Examples

1. A patient presents with elbow pain and swelling after a fall; the healthcare provider orders a CPT 73080 examination to assess for a possible fracture.
2. A patient with a history of rheumatoid arthritis experiences increased pain and stiffness in the elbow; a CPT 73080 examination is ordered to evaluate the joint for signs of worsening arthritis.
3. A patient with a known bone spur in the elbow reports worsening symptoms; a CPT 73080 examination is performed to assess the size and location of the bone spur.
4. A patient presents with a suspected dislocation of the elbow; a CPT 73080 examination is ordered to confirm the diagnosis and guide treatment.
5. A patient with a history of a previous elbow fracture experiences new pain and limited range of motion; a CPT 73080 examination is performed to evaluate the healing process and identify any complications.
6. A patient with a congenital elbow abnormality requires a CPT 73080 examination to assess the anatomy and plan for potential surgical intervention.
7. A patient with a known elbow tumor requires a CPT 73080 examination to monitor the size and progression of the tumor.
8. A patient with a suspected infection in the elbow joint requires a CPT 73080 examination to evaluate the extent of the infection and guide treatment.
9. A patient with a history of elbow surgery experiences new pain and instability in the joint; a CPT 73080 examination is ordered to assess the surgical site and identify any complications.
10. A patient with a suspected foreign body in the elbow requires a CPT 73080 examination to locate the object and plan for removal.