How To Use CPT Code 73560

CPT 73560 refers to a radiologic examination of the knee with one or two views, and this article will cover its description, procedure, qualifying circumstances, usage, documentation requirements, billing guidelines, historical information, similar codes, and examples.

1. What is CPT 73560?

CPT 73560 is a medical billing code used to describe a radiologic examination of the knee joint, specifically when one or two X-ray views are taken. This procedure is performed to diagnose and evaluate various knee conditions, such as fractures, swelling, or pain, by obtaining detailed images of the knee joint using X-ray technology.

2. 73560 CPT code description

The official description of CPT code 73560 is: “Radiologic examination, knee; 1 or 2 views.”

3. Procedure

The 73560 procedure involves the following steps:

1. The patient is positioned appropriately for the X-ray examination, depending on the specific views required.
2. The X-ray machine is adjusted to target the knee joint and capture the desired views.
3. The X-ray technician instructs the patient to remain still while the X-ray images are taken.
4. One or two X-ray views of the knee joint are captured, with the images recorded on special film or a computer.
5. The radiologist reviews and interprets the X-ray images to diagnose and evaluate the patient’s knee condition.

4. Qualifying circumstances

Patients eligible to receive CPT code 73560 services are those who present with symptoms or conditions that warrant a radiologic examination of the knee joint. These may include, but are not limited to:

• Knee pain or discomfort
• Swelling or inflammation in the knee area
• Decreased range of motion or mobility issues
• Suspected fractures or dislocations
• Postoperative evaluation of the knee joint
• Monitoring of known knee conditions or diseases

5. When to use CPT code 73560

It is appropriate to bill the 73560 CPT code when a healthcare provider performs a radiologic examination of the knee joint, capturing one or two X-ray views, to diagnose or evaluate a patient’s knee condition. This code should be used when the examination is medically necessary and supported by the patient’s symptoms, medical history, and physical examination findings.

6. Documentation requirements

To support a claim for CPT 73560, the healthcare provider must document the following information:

• Indication for the radiologic examination, including the patient’s symptoms, medical history, and physical examination findings
• Specific views taken during the examination, including the patient’s body position and projection of the X-ray
• Interpretation and findings of the X-ray images, including any diagnoses or evaluations made by the radiologist
• Any recommendations for further evaluation, treatment, or follow-up care

7. Billing guidelines

When billing for CPT code 73560, keep in mind the following guidelines and tips:

• Ensure that the provider’s documentation clearly describes each view taken during the radiologic examination.
• If reporting only the physician’s interpretation of the radiology service, append professional component modifier 26 to the radiology code.
• If reporting only the technical component of the radiology service, append modifier TC to the radiology code. Note that payer policy may exempt hospitals from appending modifier TC, as the hospital’s portion is inherently technical.
• Do not append a professional or technical modifier to the radiology code when reporting a global service in which one provider renders both the professional and technical components.

8. Historical information

CPT 73560 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, knee; one or two views.”

9. Similar codes to CPT 73560

Five similar codes to CPT 73560 and how they differentiate are:

• CPT 73562: This code is used for radiologic examinations of the knee with three views, providing more comprehensive imaging than CPT 73560.
• CPT 73564: This code is used for radiologic examinations of the knee with four or more views, offering the most detailed imaging of the knee joint.
• CPT 73550: This code is used for radiologic examinations of the hip with one or two views, focusing on a different joint than CPT 73560.
• CPT 73552: This code is used for radiologic examinations of the hip with a minimum of three views, also focusing on a different joint than CPT 73560.
• CPT 73600: This code is used for radiologic examinations of the ankle with one or two views, targeting a different joint than CPT 73560.

10. Examples

Here are 10 detailed examples of CPT code 73560 procedures:

1. A patient presents with acute knee pain after a fall, and the provider performs a radiologic examination with one view to assess for a possible fracture.
2. A patient with a history of osteoarthritis complains of worsening knee pain, and the provider performs a radiologic examination with two views to evaluate the progression of the disease.
3. A patient experiences knee swelling and discomfort following a sports injury, and the provider performs a radiologic examination with two views to determine the cause of the symptoms.
4. A patient undergoes a knee replacement surgery, and the provider performs a radiologic examination with one view to assess the postoperative alignment of the joint.
5. A patient with rheumatoid arthritis experiences increased knee stiffness, and the provider performs a radiologic examination with two views to monitor the joint’s condition.
6. A patient presents with a suspected knee dislocation, and the provider performs a radiologic examination with one view to confirm the diagnosis and plan treatment.
7. A patient complains of persistent knee pain despite conservative treatment, and the provider performs a radiologic examination with two views to evaluate the need for further intervention.
8. A patient experiences a sudden onset of knee pain and limited mobility, and the provider performs a radiologic examination with one view to assess for a possible meniscal tear.
9. A patient with a history of knee ligament injury reports increased instability, and the provider performs a radiologic examination with two views to evaluate the joint’s integrity.
10. A patient presents with unexplained knee pain and swelling, and the provider performs a radiologic examination with one view to rule out an underlying infection or inflammatory condition.