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A radiologic examination of the acromioclavicular (AC) joints is performed bilaterally, meaning that both the left and right joints are imaged during the procedure. This examination utilizes X-ray imaging, which employs indirect ionizing radiation to create detailed pictures of the internal structures of the body. The principle behind X-ray imaging is based on the varying densities and compositions of different materials, such as human tissues. When X-rays are directed towards the body, some rays are absorbed by denser materials, while others pass through and are captured on a detector, resulting in a two-dimensional image that reveals the anatomical structures of the AC joints. The AC joints, located where the collarbone meets the highest point of the shoulder blade, are critical for shoulder stability and movement. Injuries to these joints can be effectively assessed using standard anteroposterior (AP) views, which provide a clear perspective of the joint's condition. In a bilateral examination, a comparison view is also taken of the opposite shoulder to aid in diagnosis. The AP view is typically captured with the patient's head inclined approximately 15 degrees along the spine of the scapula, optimizing the imaging angle for better visualization of the joint. Historically, stress or weighted images were utilized to differentiate between partial and complete ligamentous tears in the AC joint. However, current medical practice has shifted towards nonsurgical treatment for both types of tears, leading to a decline in the use of weighted distraction images. As a result, these images are now largely considered obsolete in contemporary diagnostic procedures for AC joint injuries.
© Copyright 2025 Coding Ahead. All rights reserved.
The radiologic examination of the acromioclavicular joints is indicated for various conditions and symptoms that may affect the integrity and function of the shoulder. These indications include:
The procedure for conducting a radiologic examination of the acromioclavicular joints involves several key steps to ensure accurate imaging and assessment of the joints. These steps include:
After the radiologic examination of the acromioclavicular joints, the images are reviewed by a radiologist or qualified healthcare professional. The results are interpreted to identify any abnormalities, such as fractures, dislocations, or signs of ligamentous injury. Patients may be advised on the next steps based on the findings, which could include further imaging, physical therapy, or other treatment options. It is important for patients to follow any post-procedure instructions provided by their healthcare provider, especially if additional evaluations or interventions are necessary.
| Short Descr | X-RAY EXAM OF SHOULDERS | Medium Descr | RADEX A-C JOINTS BI W/WO WEIGHTED DISTRCJ | Long Descr | Radiologic examination; acromioclavicular joints, bilateral, with or without weighted distraction | Status Code | Active Code | Global Days | XXX - Global Concept Does Not Apply | PC/TC Indicator (26, TC) | 1 - Diagnostic Tests for Radiology Services | Multiple Procedures (51) | 0 - No payment adjustment rules for multiple procedures apply. | Bilateral Surgery (50) | 2 - 150% payment adjustment does NOT apply. | Physician Supervisions | 09 - Concept does not apply. | Assistant Surgeon (80, 82) | 0 - Payment restriction for assistants at surgery applies to this procedure... | Co-Surgeons (62) | 0 - Co-surgeons not permitted for this procedure. | Team Surgery (66) | 0 - Team surgeons not permitted for this procedure. | Diagnostic Imaging Family | 99 - Concept Does Not Apply | APC Status Indicator | STV-Packaged Codes | ASC Payment Indicator | Packaged service/item; no separate payment made. | Type of Service (TOS) | 4 - Diagnostic Radiology | Berenson-Eggers TOS (BETOS) | I1B - Standard imaging - musculoskeletal | MUE | 1 | CCS Clinical Classification | 226 - Other diagnostic radiology and related techniques |
| 52 | Reduced services: under certain circumstances a service or procedure is partially reduced or eliminated at the discretion of the physician or other qualified health care professional. under these circumstances the service provided can be identified by its usual procedure number and the addition of modifier 52, signifying that the service is reduced. this provides a means of reporting reduced services without disturbing the identification of the basic service. note: for hospital outpatient reporting of a previously scheduled procedure/service that is partially reduced or cancelled as a result of extenuating circumstances or those that threaten the well-being of the patient prior to or after administration of anesthesia, see modifiers 73 and 74 (see modifiers approved for asc hospital outpatient use). | 26 | Professional component: certain procedures are a combination of a physician or other qualified health care professional component and a technical component. when the physician or other qualified health care professional component is reported separately, the service may be identified by adding modifier 26 to the usual procedure number. | FY | X-ray taken using computed radiography technology/cassette-based imaging | LT | Left side (used to identify procedures performed on the left side of the body) | 59 | Distinct procedural service: under certain circumstances, it may be necessary to indicate that a procedure or service was distinct or independent from other non-e/m services performed on the same day. modifier 59 is used to identify procedures/services, other than e/m services, that are not normally reported together, but are appropriate under the circumstances. documentation must support a different session, different procedure or surgery, different site or organ system, separate incision/excision, separate lesion, or separate injury (or area of injury in extensive injuries) not ordinarily encountered or performed on the same day by the same individual. however, when another already established modifier is appropriate it should be used rather than modifier 59. only if no more descriptive modifier is available, and the use of modifier 59 best explains the circumstances, should modifier 59 be used. note: modifier 59 should not be appended to an e/m service. to report a separate and distinct e/m service with a non-e/m service performed on the same date, see modifier 25. | RT | Right side (used to identify procedures performed on the right side of the body) | TC | Technical component; under certain circumstances, a charge may be made for the technical component alone; under those circumstances the technical component charge is identified by adding modifier 'tc' to the usual procedure number; technical component charges are institutional charges and not billed separately by physicians; however, portable x-ray suppliers only bill for technical component and should utilize modifier tc; the charge data from portable x-ray suppliers will then be used to build customary and prevailing profiles | GC | This service has been performed in part by a resident under the direction of a teaching physician | AQ | Physician providing a service in an unlisted health professional shortage area (hpsa) | 50 | Bilateral procedure: unless otherwise identified in the listings, bilateral procedures that are performed at the same session, should be identified by adding modifier 50 to the appropriate 5 digit code. note: this modifier should not be appended to designated "add-on" codes (see appendix d). | 76 | Repeat procedure or service by same physician or other qualified health care professional: it may be necessary to indicate that a procedure or service was repeated by the same physician or other qualified health care professional subsequent to the original procedure or service. this circumstance may be reported by adding modifier 76 to the repeated procedure or service. note: this modifier should not be appended to an e/m service. | 77 | Repeat procedure by another physician or other qualified health care professional: it may be necessary to indicate that a basic procedure or service was repeated by another physician or other qualified health care professional subsequent to the original procedure or service. this circumstance may be reported by adding modifier 77 to the repeated procedure or service. note: this modifier should not be appended to an e/m service. | CR | Catastrophe/disaster related | FX | X-ray taken using film | GA | Waiver of liability statement issued as required by payer policy, individual case | GP | Services delivered under an outpatient physical therapy plan of care | GW | Service not related to the hospice patient's terminal condition | GY | Item or service statutorily excluded, does not meet the definition of any medicare benefit or, for non-medicare insurers, is not a contract benefit | PC | Wrong surgery or other invasive procedure on patient | Q6 | Service furnished under a fee-for-time compensation arrangement by a substitute physician or by a substitute physical therapist furnishing outpatient physical therapy services in a health professional shortage area, a medically underserved area, or a rural area | X5 | Diagnostic services requested by another clinician: for reporting services by a clinician who furnishes care to the patient only as requested by another clinician or subsequent and related services requested by another clinician; this modifier is reported for patient relationships that may not be adequately captured by the above alternative categories; reporting clinician service examples include but are not limited to, the radiologist's interpretation of an imaging study requested by another clinician |
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