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How To Code Chest X Ray – CPT 71045, CPT 71046, CPT 71047 & CPT 71048

Are you looking for the Chest X Ray CPT Codes? Underneath four codes that can be reported for this procedure.

The 71045 CPT code can be billed for chest x ray single view, the 71046 CPT code can be used to report two views.

If the chest x ray is performed with three views bill the 71047 CPT code and bill CPT 71048 for four or more views.

What Is Chest X-Ray?

A chest X-Ray provides a view of the the organ and musculoskeletal level that includes lungs, bronchi, heart, major vessels (aorta, pulmonary vessels and vena cava) and bones like sternum, ribs, clavicle, scapula, spine).

Although chest X-Ray is a common investigative tests ordered in outpatient setting, post COVID chest X-Ray are very common to code.

Different Views Chest X Ray CPT Codes

The total number of X-Ray views is the key to select the appropriate chest X Ray CPT Code. The views of X-Rays could be obtained by positioning in different angles. Coders should identify the documentation that relates to separate views to decide on the number of views. 

Frontal View or Anteroposterior View: Patient are positioned facing the X-Ray machine.

Posteroanterior: Patient’s back is positioned towards the X-ray machine.

Lateral View: Patient’s side of the chest is positioned towards the X-Ray machine.

Oblique views Additional images to view heart and great vessels and in the case of rib fractures and intrathoracic lesions (RAO also used routinely used in barium esophagography).

Lateral Decubitus view: Patient is positioned by lying on the side. A problem-solving film used to distinguish pneumothorax versus pleural effusion and pneumothorax versus pneumomediastinum.

Patient may be positioned standing with chest rotated 45 degrees to obtain anterior oblique view. While to obtain posterior oblique view, patient may be positioned in lying as too ill to be in standing position.

The coder should assign and report the relevant Chest X Ray cpt code based on the number of views.

Description of the type of view for the study is NO longer a required element for coding documentation. Some doctors may opt to continue detailing the different types of views performed.

The coder should not presume that the reporting requirement has been satisfied if the number of views is not stated in the report. Instead, the coder should collaborate closely with the interpreting physician in order to clarify and gather the necessary information.

This will help ensure that all relevant information is recorded and that the claim submission contains the right CPT imaging code. 

Chest X Ray CPT Codes

There are four CPT codes that can be used for Chest X Ray. CPT 71046 can be used to code single view, CPT 71046 can be billed for two views, CPT 71047 for three views and the last CPT code 71048 for four views or more.

CPT Code 71045 For X Ray Chest Single View

The first chest X Ray CPT Code is the 71045 CPT code and can be billed for X-Ray of the chest single view.

This code has replaced CPT code 71010 (single view, frontal) and CPT 71015 (stereo, frontal) in 2018. CPT 71045 is defined underneath.

Description: Radiologic examination of the chest. Single view.

CPT Code 71046 For X-Ray Chest Two Views

The second Chest X Ray CPT code is the 71046 CPT code can be billed for X-Ray of the chest two views.

This code has replaced the following codes in 2018. CPT 71021 (2 views with apical lordotic procedure), CPT 71022 (2 views with oblique projections) and CPT 71023 (2 views with fluoroscopy).

CPT 71046 can be used for all type of single view X-ray of the chest and is defined below.

Description: Radiologic examination of the chest. Single view.

CPT Code 71047 For X-Ray Chest Three Views

The third Chest X Ray CPT code is the 71047 CPT code and is not used as often as the other CPT codes for chest X-ray.

This CPT code can be used when a X-Ray procedure is performed of the chest with three views. CPT 71047 is defined below.

Description: Radiologic examination of the chest. 3 views.

CPT Code 71048 For X-Ray Chest Four Views Or More

The last Chest X Ray CPT Code is the 71048 CPT which can be used to bill X-Rays of the chest with four or more views.

This code has replaced CPT 71022, CPT 71030, CPT 71034 and CPT 71035 in 2018 and is defined as below.

Description: Radiologic examination of the chest. Four or more views.

Chest X-Ray CPT Codes 2016 vs. 2018

Coders will need to be on top of coding guidelines Chest X Ray CPT codes and should be aware of the deleted codes in past years.

Use of deleted codes will result in denials. In 2018, codes for chest X-rays were simplified: Nine codes are deleted and replaced by four new codes, which are based solely on the number of views.

The following nine Chest X-Ray CPT codes from 2016 are deleted and replaced in 2018.

CPT 71035: (Deleted) Radiologic examination of the chest, special views

CPT 71034: (Deleted) Radiologic examination of the chest. Complete and a minimum of four views with fluoroscopy

CPT 71030: (Deleted) Radiologic examination of the chest. Complete and a minimum of four views.

CPT 71023: (Deleted) Radiologic examination of the chest with two views. Frontal and lateral with fluoroscopy.

CPT 71022: (Deleted) Radiologic examination of the chest with two views. Frontal and lateral with oblique projections.

CPT 71021: (Deleted) Radiologic examination of the chest with two views. Frontal and lateral with apical lordotic procedure.

CPT 71020: (Deleted) Radiologic examination of the chest with two views. Frontal and lateral.

CPT 71015: (Deleted) Radiologic examination of the chest. Stereo and frontal.

CPT 71010: (Deleted) Radiologic examination of the chest. Single view and frontal.

The table below explains how the new Chest X Ray CPT codes from 2018 replace the old ones from 2016.

Deleted Chest X-Ray CodeNew Chest X-Ray Code
CPT 71010Replaced by CPT 71045
CPT 71015Replaced by CPT 71045
CPT 71020Replaced by CPT 71046
CPT 71021Replaced by CPT 71047
CPT 71022Replaced by CPT 71047 and CPT 71048
CPT 71023Replaced by CPT 71046 and CPT 76000
CPT 71030Replaced by CPT 71048
CPT 71034Replaced by CPT 71048 and CPT 76000
CPT 71035Replaced by CPT 71046, CPT 71047 and CPT 71048
Replaced Chest X-Ray CPT Codes (2016 vs. 2018)

Billing Guidelines & Reimbursement

Report R0070 and R0075 for the transportation of portable x-ray equipment and personnel that may be used.  

For acute abdomen series (including a single view chest x-ray) see the 74022 CPT code. Check with the specific payer to determine coverage. 

Medical Necessity

The following is considered not reasonable or medically necessary. Pre-procedural chest X-rays:

  • in the absence of symptomatic pulmonary or cardiac illness;
  • in the absence of signs or symptoms;
  • for mild head trauma;
  • for lower back trauma; or
  • extremity trauma.

Documention

The reason/reasons for the radiograph must be noted in the documentation if a patient with known but stable pulmonary illness or asymptomatic cardiac requires a x-ray of the cest.

The documentation needs to include an explanation of how the X-ray data will be used in the patient’s treatment.

The reason/reasons for the chest x-ray must be noted in the clinical records in case of pre procedural procedure if a patient with known but stable, asymptomatic cardiac or pulmonary illness requires it.

The records needs to include an explanation of how the x-ray will be used for the treatment of the patient.

Include a record that explains how the x-ray data will be utilized to inform treatment decisions for patients with symptomatic cardiac or pulmonary problems who are considering surgery in an outpatient facility or ASC.

Abnormal Chest X-Ray ICD 10

The ICD 10 code for abormal chest can be needed to bill the CPT codes for Chest X-ray. Report the ICD 10 CM R91.8 (Other nonspecific abnormal finding of lung field) if requested.

Reimbursement

Reimbursement fees for the Chest X-Ray CPT codes are listed below.

ModifierWork RVUNon Fac PE RVUFac PE RVUMP RVUNon-Fac TotalFac TotalPCTC IND
CPT 710450.180.550.550.020.750.751
CPT 71045TC0.000.480.480.010.490.491
CPT 71045260.180.070.070.010.260.261
CPT 710460.220.740.740.020.980.981
CPT 71046TC0.000.660.660.010.670.671
CPT 71046260.220.080.080.010.310.311
CPT 710470.270.950.950.021.241.241
CPT 71047TC0.000.840.840.010.850.851
CPT 71047260.270.110.110.010.390.391
CPT 710480.311.001.000.021.331.331
CPT 71048TC0.000.870.870.010.880.881
CPT 71048261.310.130.130.010.450.451
Reimbursement Payment Under The Physician Fee Schedule

Medically Unlikely Edits

Underneath the MUE’s for CPT 71045, CPT 71046, CPT 71047 and CPT 71048.

Practioner Service MUE ValuesOutpatient Hospital Services MUE Values
CPT 7104544
CPT 7104623
CPT 7104712
CPT 7104811
MUEs for Chest X-Ray CPT Codes

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