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Diagnostic Radiology Current Procedural Terminology Updates for 2018

By   Melissa Okerson

December 15, 2017

Several Current Procedural Terminology (CPT) changes for reporting chest and abdominal X-rays are being introduced for 2018. The following is a brief overview of significant diagnostic radiology modifications for next year. For complete descriptions of the new, deleted and revised codes, please review the 2018 CPT Code Book. While the below information pertains only to chest and abdominal X-ray changes for 2018, CPT has a total of 170 code additions, 82 deletions and 60 revisions.

Chest Exam Codes
Chest radiologic exam codes 71010 (chest X-ray; single view frontal) and 71020 (chest X-ray; two views frontal and lateral) have been identified as high-expenditure services. As a result, revisions have been made in order to remove view-specific codes (e.g., frontal, apical, oblique) and to replace them with codes that specify the number of views. The intent of the new codes is to simplify the reporting of these services.

These revisions include the deletion of nine codes (71010, 71015, 71020, 71021, 71022, 71023, 71030, 71034, 71035) and the addition four new codes:

  • 71045    Radiologic examination, chest; single view
  • 71046    two views
  • 71047    three views
  • 71048    four or more views

It’s important to remember that the number of views does not equal the number of images. It may take more than one image to perform a complete view.

References to the deleted chest X-ray codes have been deleted and replaced throughout the code set with the new codes, including in the Critical Care guidelines and Coding Tip, Pediatric and Neonatal Critical Care guidelines, and the parenthetical notes following codes 0174T and 0175T.

Abdominal Exam Codes
Abdominal X-ray codes 74000 (abdominal X-ray; single anteroposterior view) and 74022 (complete abdominal series) have also been identified as high-expenditure services. As a result, three view-specific codes (74000, 74010, 74020) have been deleted and three new codes that specify the number of views have been added:

  • 74018    Radiologic examination, abdomen; one view
  • 74019    two views
  • 71021    three or more views

Again, it is imperative to remember that the number of views does not equal the number of images. It may take more than one image to perform a complete view (e.g., oblique, cone, decubitus).

As part of these revisions, the parenthetical note in the Gynecological and Obstetrical section has been revised to reflect the deletion of code 74000 and addition of codes 74018, 74019, and 74021.

CPT code 74022 (complete acute abdomen series) which includes view-specific language, has been retained as this code is used to report a specific service that requires certain views in order to accomplish the service.

We recommend coding and billing staff refer to the 2018 CPT Code Book for all updates and make the necessary adjustments to edit billing and EMR systems.