How To Use CPT Code 73562

CPT 73562 is a radiologic examination code for the knee with three 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 73562?

CPT 73562 is a medical billing code used for radiologic examinations of the knee joint, specifically when three views are taken. This code is utilized by healthcare providers to accurately document and bill for the services provided during a knee radiologic examination with three views.

2. 73562 CPT code description

The official description of CPT code 73562 is: “Radiologic examination, knee; 3 views.”

3. Procedure

The 73562 procedure involves the following steps:

1. The patient is positioned appropriately for the knee X-ray examination.
2. The X-ray machine is adjusted to focus on the knee joint.
3. Three different views of the knee joint are taken, capturing images from various angles.
4. The images are recorded on special film or a computer for further analysis.
5. The healthcare provider reviews the images to assess the condition of the knee joint and identify any abnormalities.

4. Qualifying circumstances

Patients who are eligible to receive CPT code 73562 services include those experiencing knee pain, swelling, or other symptoms that may indicate a knee joint issue. Additionally, patients with a history of knee injuries or conditions may also qualify for this radiologic examination. Healthcare providers should use their clinical judgment to determine if a patient meets the criteria for CPT 73562.

5. When to use CPT code 73562

It is appropriate to bill the 73562 CPT code when a healthcare provider performs a radiologic examination of the knee joint with three views. This code should be used when the examination is necessary to diagnose or assess a patient’s knee condition, such as identifying fractures, inflammation, or other abnormalities.

6. Documentation requirements

To support a claim for CPT 73562, healthcare providers must document the following information:

• The patient’s medical history and symptoms related to the knee joint.
• The clinical rationale for performing the radiologic examination with three views.
• A detailed description of each view taken during the examination, including the patient’s body position and projection of the X-ray.
• The findings and interpretation of the radiologic examination, including any identified abnormalities or issues with the knee joint.

7. Billing guidelines

When billing for CPT code 73562, healthcare providers should adhere to the following guidelines:

• If only the physician’s interpretation of the radiology service is being reported, append professional component modifier 26 to the radiology code.
• If only the technical component of the radiology service is being reported, append modifier TC to the radiology code. Note that some payer policies may exempt hospitals from appending modifier TC, as their 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 73562 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; three views.”

9. Similar codes to CPT 73562

Five similar codes to CPT 73562 and how they differentiate are:

• CPT 73560: This code is used for radiologic examinations of the knee with one or two views, rather than three.
• CPT 73564: This code is used for a complete knee series, consisting of four or more views.
• CPT 73565: This code is used for a bilateral knee examination, which involves both knees being examined.
• CPT 73550: This code is used for radiologic examinations of the hip with one view, focusing on a different joint than the knee.
• CPT 73600: This code is used for radiologic examinations of the ankle with two views, focusing on a different joint than the knee.

10. Examples

Here are 10 detailed examples of CPT code 73562 procedures:

1. A patient presents with acute knee pain after a sports injury, and the healthcare provider orders a radiologic examination with three views to assess for fractures or dislocations.
2. A patient with a history of osteoarthritis complains of worsening knee pain, and the healthcare provider orders a radiologic examination with three views to evaluate the progression of the condition.
3. A patient experiences knee swelling and redness, and the healthcare provider orders a radiologic examination with three views to rule out infection or inflammation.
4. A patient with a known meniscal tear is scheduled for surgery, and the healthcare provider orders a radiologic examination with three views to assess the extent of the damage and plan the surgical approach.
5. A patient presents with chronic knee pain and instability, and the healthcare provider orders a radiologic examination with three views to evaluate the integrity of the ligaments and joint structures.
6. A patient with a history of rheumatoid arthritis complains of new-onset knee pain, and the healthcare provider orders a radiologic examination with three views to assess for joint erosion or other complications.
7. A patient experiences knee pain and limited range of motion after a fall, and the healthcare provider orders a radiologic examination with three views to rule out fractures or dislocations.
8. A patient with a known patellar subluxation experiences recurrent knee pain, and the healthcare provider orders a radiologic examination with three views to evaluate the alignment of the patella and joint structures.
9. A patient presents with knee pain and a palpable mass, and the healthcare provider orders a radiologic examination with three views to assess for possible tumors or cysts.
10. A patient with a history of knee surgery complains of persistent pain and clicking, and the healthcare provider orders a radiologic examination with three views to evaluate the integrity of the surgical repair and joint structures.