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Official Description

Manual application of stress performed by physician or other qualified health care professional for joint radiography, including contralateral joint if indicated

© Copyright 2025 American Medical Association. All rights reserved.

Common Language Description

The CPT® Code 77071 refers to the manual application of stress to a joint during radiographic imaging, which is performed by a physician or another qualified healthcare professional. This procedure is essential for obtaining detailed images of the joint under conditions that may not be visible in standard X-ray views. The process involves the healthcare provider wearing protective gloves and applying manual stress to the joint being examined. This stress is applied while the joint is held in a specific position, allowing for enhanced visualization of the joint's structure and any potential abnormalities. Additionally, if indicated, the contralateral joint may also be subjected to the same manual stress application to provide comparative imaging. This technique is particularly useful in diagnosing joint conditions, as it reveals insights into the joint's stability and integrity that are not apparent in routine imaging techniques.

© Copyright 2025 Coding Ahead. All rights reserved.

1. Indications

The manual application of stress during joint radiography, as described by CPT® Code 77071, is indicated for various clinical scenarios where enhanced visualization of joint structures is necessary. The following conditions may warrant this procedure:

  • Joint Instability - To assess the stability of a joint that may be prone to dislocation or subluxation.
  • Suspected Ligamentous Injury - To evaluate potential damage to ligaments surrounding the joint.
  • Joint Pain - In cases of unexplained joint pain where further investigation is required to determine the underlying cause.
  • Post-Trauma Assessment - To examine joints after an injury to ascertain any structural damage that may not be visible in standard X-rays.

2. Procedure

The procedure for manual application of stress during joint radiography involves several key steps to ensure accurate imaging and patient safety. The following procedural steps are outlined:

  • Step 1: Preparation - The healthcare professional prepares the patient for the procedure by explaining the process and obtaining informed consent. The patient is positioned appropriately to allow access to the joint being examined.
  • Step 2: Application of Protective Measures - The physician or qualified healthcare professional dons protective gloves to maintain hygiene and prevent contamination during the procedure.
  • Step 3: Manual Stress Application - The provider applies manual stress to the joint while ensuring it is held in the desired position. This step is crucial as it allows for the assessment of the joint under conditions that may not be visible in standard imaging.
  • Step 4: Radiographic Imaging - With the joint under stress, X-rays are taken to capture detailed images. The imaging may include views of the contralateral joint if indicated, providing a comparative analysis.
  • Step 5: Post-Procedure Assessment - After the imaging is completed, the healthcare professional evaluates the images for any abnormalities and discusses the findings with the patient, if appropriate.

3. Post-Procedure

Following the manual application of stress and subsequent radiographic imaging, the patient may be monitored for any immediate discomfort or adverse reactions. It is important to provide post-procedure care instructions, which may include recommendations for rest, ice application, or over-the-counter pain relief if necessary. The healthcare provider will review the imaging results with the patient and discuss any further diagnostic or treatment options based on the findings. Additionally, any follow-up appointments or referrals to specialists may be arranged as needed to address the underlying joint issues identified during the procedure.

Short Descr MNL APPL STRS JT RADIOGRAPHY
Medium Descr MANUAL APPL STRESS PHYS/QHP JOINT RADIOGRAPHY
Long Descr Manual application of stress performed by physician or other qualified health care professional for joint radiography, including contralateral joint if indicated
Status Code Active Code
Global Days XXX - Global Concept Does Not Apply
PC/TC Indicator (26, TC) 2 - Professional Component Only Code
Multiple Procedures (51) 0 - No payment adjustment rules for multiple procedures apply.
Bilateral Surgery (50) 2 - 150% payment adjustment does NOT apply.
Physician Supervisions 03 - Procedure must be performed under the personal supervision of physician.
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
RT Right side (used to identify procedures performed on the right side of the body)
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.
GC This service has been performed in part by a resident under the direction of a teaching physician
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).
58 Staged or related procedure or service by the same physician or other qualified health care professional during the postoperative period: it may be necessary to indicate that the performance of a procedure or service during the postoperative period was: (a) planned or anticipated (staged); (b) more extensive than the original procedure; or (c) for therapy following a surgical procedure. this circumstance may be reported by adding modifier 58 to the staged or related procedure. note: for treatment of a problem that requires a return to the operating/procedure room (eg, unanticipated clinical condition), see modifier 78.
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.
78 Unplanned return to the operating/procedure room by the same physician or other qualified health care professional following initial procedure for a related procedure during the postoperative period: it may be necessary to indicate that another procedure was performed during the postoperative period of the initial procedure (unplanned procedure following initial procedure). when this procedure is related to the first, and requires the use of an operating/procedure room, it may be reported by adding modifier 78 to the related procedure. (for repeat procedures, see modifier 76.)
79 Unrelated procedure or service by the same physician or other qualified health care professional during the postoperative period: the individual may need to indicate that the performance of a procedure or service during the postoperative period was unrelated to the original procedure. this circumstance may be reported by using modifier 79. (for repeat procedures on the same day, see modifier 76.)
82 Assistant surgeon (when qualified resident surgeon not available): the unavailability of a qualified resident surgeon is a prerequisite for use of modifier 82 appended to the usual procedure code number(s).
AQ Physician providing a service in an unlisted health professional shortage area (hpsa)
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
F4 Left hand, fifth digit
F6 Right hand, second digit
F7 Right hand, third digit
F8 Right hand, fourth digit
F9 Right hand, fifth digit
FY X-ray taken using computed radiography technology/cassette-based imaging
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
GZ Item or service expected to be denied as not reasonable and necessary
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
SG Ambulatory surgical center (asc) facility service
T1 Left foot, second digit
T6 Right foot, second digit
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
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
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
XE Separate encounter, a service that is distinct because it occurred during a separate encounter
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
Date
Action
Notes
2025-01-01 Changed Short and Medium Descriptions changed.
2013-01-01 Changed Description Changed
2011-04-04 Changed Bilateral surgery indicator changed to 2
2007-01-01 Added First appearance in code book in 2007.
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