The AMA overhauled chest x-ray codes a few years ago, replacing the old codes with a strict "number of views" system. CPT 71045 represents a single-view chest x-ray (usually a PA or AP view).
Counting the Views
You must count the exact number of radiographic views taken:
- 71045: Radiologic examination, chest; single view.
- 71046: Two views (e.g., PA and Lateral).
- 71047: Three views.
- 71048: Four or more views.
Medical Necessity
Routine chest x-rays for asymptomatic patients (e.g., preoperative clearance without cardiac/pulmonary symptoms) are frequently denied by Medicare. Valid indications include cough (R05.9) or shortness of breath (R06.02).
NCCI Edits
If a single view (71045) is taken in the morning, and the patient deteriorates requiring a two-view (71046) in the afternoon, appropriate modifiers (like 59 or XE) are required to bypass mutually exclusive edits.