How To Use CPT Code 73564

CPT 73564 involves a radiologic examination of the knee with four or more views. This article will cover the description, procedure, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information, similar codes, and examples of CPT code 73564 procedures.

1. What is CPT 73564?

CPT 73564 is a medical billing code used for radiologic examinations of the knee joint, specifically when four or more views are taken. This code is utilized by medical professionals to accurately document and bill for this specific type of knee examination.

2. 73564 CPT code description

The official description of CPT code 73564 is: “Radiologic examination, knee; complete, 4 or more views.”

3. Procedure

The 73564 procedure involves the following steps:

1. The patient is positioned appropriately for the examination.
2. The X-ray machine is adjusted to target the knee joint.
3. Four or more X-ray views are taken of the knee joint, capturing different angles and projections.
4. The images are recorded on special film or a computer for further analysis.
5. The radiologist interprets the images to diagnose any issues with the knee joint, such as fractures, swelling, or other causes of pain.

4. Qualifying circumstances

Patients who are eligible to receive CPT code 73564 services include those experiencing knee pain, swelling, or other symptoms that warrant a thorough examination of the knee joint. This may include individuals with a history of knee injuries, arthritis, or other conditions affecting the knee. The provider must determine that four or more views are necessary to accurately diagnose the patient’s condition.

5. When to use CPT code 73564

It is appropriate to bill the 73564 CPT code when a provider performs a radiologic examination of the knee joint with four or more views. This code should be used when the provider determines that a comprehensive examination is necessary to accurately diagnose the patient’s condition and when the documentation supports the need for four or more views.

6. Documentation requirements

To support a claim for CPT 73564, the provider’s documentation should include:

• A detailed description of the patient’s symptoms and medical history.
• The reason for the examination and the necessity of four or more views.
• A description of each view taken, including the patient’s body position and the projection of the X-ray.
• The radiologist’s interpretation of the images and any findings or diagnoses.

7. Billing guidelines

When billing for CPT code 73564, keep the following guidelines in mind:

• Append professional component modifier 26 to the radiology code if reporting only the physician’s interpretation for the radiology service.
• Append modifier TC to the radiology code if reporting only the technical component for the radiology service. Note that payer policy may exempt hospitals from appending modifier TC because 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 73564 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; complete, four or more views.”

9. Similar codes to CPT 73564

Five similar codes to CPT 73564 and how they differentiate are:

1. CPT 73560: This code is used for radiologic examinations of the knee with one or two views.
2. CPT 73562: This code is used for radiologic examinations of the knee with three views.
3. CPT 73565: This code is used for a standing X-ray examination of both knees, specifically for the evaluation of osteoarthritis.
4. CPT 73550: This code is used for radiologic examinations of the femur, including the hip joint and knee joint, with a minimum of two views.
5. CPT 73552: This code is used for radiologic examinations of the entire lower extremity, including the hip, knee, and ankle joints, with a minimum of two views.

10. Examples

Here are 10 detailed examples of CPT code 73564 procedures:

1. A patient with a history of knee pain and swelling undergoes a radiologic examination with four views to evaluate for possible arthritis.
2. A patient who experienced a recent knee injury has a radiologic examination with five views to assess for fractures or ligament damage.
3. A patient with chronic knee pain and a history of multiple knee surgeries undergoes a radiologic examination with four views to evaluate the stability of the joint.
4. A patient with suspected meniscal tears has a radiologic examination with four views to determine the extent of the damage.
5. A patient with a known knee deformity undergoes a radiologic examination with six views to plan for corrective surgery.
6. A patient with a history of knee dislocations has a radiologic examination with four views to assess joint stability and alignment.
7. A patient with unexplained knee pain and a family history of rheumatoid arthritis undergoes a radiologic examination with four views to evaluate for early signs of the disease.
8. A patient with a suspected infection in the knee joint has a radiologic examination with four views to assess for joint space narrowing or bone erosion.
9. A patient with a history of knee pain and a recent increase in symptoms undergoes a radiologic examination with five views to evaluate for possible progression of joint degeneration.
10. A patient with a history of knee pain and a recent fall has a radiologic examination with four views to assess for possible fractures or dislocations.