Q/A: Can we report a chest x-ray done before ET tube placement?
APCs Insider, August 2, 2013
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Q: Last week, you said that a modifier should not be used when a chest x-ray is done to check the placement of the endotracheal (ET) tube (CPT® code 31500). What if the chest x-ray was done prior to the emergency intubation and for another reason? For example, the patient has trauma from a car accident and they are doing a chest x-ray to evaluate any trauma to the chest area. Can we report that chest x-ray with a modifier?
A: In the circumstances you note, the physician ordered the chest x-ray for a medically necessary reason that was not related to the emergency intubation.
In this case, the chest x-ray was separate and distinct from the emergency intubation procedure, and you should report it with a modifier. As always, ensure that the documentation in the record supports the services being reported.
Editor’s note: Andrea Clark, RHIA, CCS, CPCH, chairman, CEO, and founder of Health Revenue Assurance Associates, Inc., in Plantation, Fla., answered this question.
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