CPT Code 73564 | Description, Procedure & Billing Guidelines (2022)
You can bill CPT code 73564 for four or more X-ray views of the patient’s knee to find the cause of pain or check swellings or fractures.
1. What Is CPT Code 73564?
CPT 73564 covers the examination of a knee joint with four radiologic (X-ray) views to check the knee swellings, fractures, or other reasons for pain.
The manual of CPT defines the 73564 CPT code as: “Radiologic examination, knee; complete, four or more views.”
A provider aims to find out what causes the pain in the knee of a patient with the 73564 CPT code procedure. He starts by placing the patient in the correct body position for the first of the four views.
Then, he takes the first image with the X-ray machine. This machine sends rays through the patient’s body. The beams pass easily through tissue, resulting in black in the image.
The bones in the patient’s knee are denser than the tissue, making it harder for the radiation beams to pass through. Therefore, it appears lighter.
The provider repeats the same process four or more times to get all the necessary views of the knee joint.
TIP: Use CPT 73560 for two views. You can find the complete billing guide here.
The images are recorded on a computer or a tape and tell the provider the cause of the pain in the patient’s knee joint.
4. How To Use CPT Code 73564
CPT code 73564 can be used for four or more X-ray views of the patient’s knee joint. Make sure that four or more views are taken by checking the provider’s documentation.
You can use CPT 73560 if the provider only took one or two X-ray views of the patient’s knee.
Do not report CPT 73564 for three views of the knee. Instead, use CPT 73562 if three X-ray images of the patient’s knee were taken.
4.1 Does CPT Code 73564 Need A Modifier?
That depends. You can use modifier 26 with CPT 73564 if you report the physician’s interpretation alone.
If you report the technical component alone, you may use modifier TC. But be aware that this might be denied for hospitals.
Do not use a modifier if CPT code 73564 if you are reporting a global service.