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A radiologic examination, specifically CPT® Code 73523, involves the imaging of both the left and right hips, and may also include the pelvis when performed. This procedure utilizes X-ray technology, which employs indirect ionizing radiation to create images of the internal structures of the body. The principle behind X-ray imaging is based on the varying densities and compositions of human tissues, which affect how X-rays are absorbed or transmitted. As a result, some X-rays pass through the body and are captured on a detector, producing a two-dimensional image that reveals the underlying anatomical structures. This examination is crucial for diagnosing various conditions, including fractures, dislocations, deformities, degenerative bone diseases, osteomyelitis, arthritis, foreign bodies, infections, or tumors. The standard views typically captured during this examination include the anteroposterior view, where the patient lies supine with legs straight and slightly rotated inward; the lateral 'frog-leg' view, which requires the hips to be flexed and abducted with knees bent and soles of the feet together; and a cross-table view, where the unaffected hip and knee are flexed at a 90-degree angle to allow the X-ray beam to be directed perpendicularly to the long axis of the femur on the affected side. Additionally, a lateral view may be taken with the hip flexed and abducted at 45 degrees, with the beam again aimed perpendicularly to the table. A pelvic view is often included, where the patient is supine and both legs are rotated slightly inward, typically about 15 degrees. For coding purposes, it is important to note that CPT® Code 73521 is used for an X-ray examination of both hips consisting of two projections, while CPT® Code 73522 is designated for a bilateral hip X-ray exam with three to four views. CPT® Code 73523 is specifically reserved for a bilateral hip examination that includes a minimum of five views, which may encompass a pelvic view as well.
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The radiologic examination of the hips, as described by CPT® Code 73523, is indicated for a variety of clinical conditions and symptoms that may affect the hip joints. These indications include:
The procedure for CPT® Code 73523 involves several specific steps to ensure comprehensive imaging of the hips and pelvis. The following procedural steps are typically performed:
After the completion of the radiologic examination, the patient may be instructed to resume normal activities unless otherwise advised by the physician. There are typically no specific post-procedure care requirements associated with this imaging study, as it is non-invasive and does not involve any recovery time. However, the physician may discuss the results of the examination with the patient during a follow-up appointment, where any necessary treatment plans or further diagnostic steps will be determined based on the findings from the X-rays. It is essential for the healthcare provider to review the images thoroughly to ensure accurate diagnosis and appropriate management of any identified conditions.
| Short Descr | X-RAY EXAM HIPS BI 5/> VIEWS | Medium Descr | RADEX HIPS BILATERAL WITH PELVIS MINIMUM 5 VIEWS | Long Descr | Radiologic examination, hips, bilateral, with pelvis when performed; minimum of 5 views | 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) | 0 - 150% payment adjustment for bilateral procedures 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 | Procedure or Service, Not Discounted when Multiple | 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 | 2 |
| 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. | 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 | 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 | 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) | GW | Service not related to the hospice patient's terminal condition | 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 | RT | Right side (used to identify procedures performed on the right side of the body) | AQ | Physician providing a service in an unlisted health professional shortage area (hpsa) | 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. | 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). | 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). | 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. | AG | Primary physician | CC | Procedure code change (use 'cc' when the procedure code submitted was changed either for administrative reasons or because an incorrect code was filed) | CR | Catastrophe/disaster related | FX | X-ray taken using film | GA | Waiver of liability statement issued as required by payer policy, individual case | GV | Attending physician not employed or paid under arrangement by the patient's hospice provider | 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 | GZ | Item or service expected to be denied as not reasonable and necessary | ME | The order for this service adheres to appropriate use criteria in the clinical decision support mechanism consulted by the ordering professional | MG | The order for this service does not have applicable appropriate use criteria in the qualified clinical decision support mechanism consulted by the ordering professional | MH | Unknown if ordering professional consulted a clinical decision support mechanism for this service, related information was not provided to the furnishing professional or provider | PD | Diagnostic or related non diagnostic item or service provided in a wholly owned or operated entity to a patient who is admitted as an inpatient within 3 days | PN | Non-excepted service provided at an off-campus, outpatient, provider-based department of a hospital | Q1 | Routine clinical service provided in a clinical research study that is in an approved clinical research study | Q5 | Service furnished under a reciprocal billing 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 | X4 | Episodic/focused services: for reporting services by clinicians who provide focused care on particular types of treatment limited to a defined period and circumstance; the patient has a problem, acute or chronic, that will be treated with surgery, radiation, or some other type of generally time-limited intervention; reporting clinician service examples include but are not limited to, the orthopedic surgeon performing a knee replacement and seeing the patient through the postoperative period | XE | Separate encounter, a service that is distinct because it occurred during a separate encounter | XP | Separate practitioner, a service that is distinct because it was performed by a different practitioner | XS | Separate structure, a service that is distinct because it was performed on a separate organ/structure | XU | Unusual non-overlapping service, the use of a service that is distinct because it does not overlap usual components of the main service |
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| 2016-01-01 | Added | Added |
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