73562
Radiologic examination, knee; 3 views
CPT code 73562 describes a diagnostic radiologic examination of the knee that includes exactly three separate views. Knee radiography remains the primary and most essential imaging modality for evaluating knee pathology due to its wide availability, speed, and cost-effectiveness. In clinical practice, the three views typically include an Anteroposterior (AP) view, a Lateral view, and a third specialized view tailored to the patient's specific clinical presentation. The AP view is often performed with the patient in a weight-bearing position to accurately assess the joint space narrowing characteristic of osteoarthritis, as well as the alignment of the femur and tibia. The Lateral view, performed with the knee flexed at approximately 20 to 30 degrees, is vital for visualizing the patellofemoral joint, the suprapatellar bursa for effusions, and the posterior aspect of the femoral condyles. The third view is commonly an oblique view, which helps in identifying subtle tibial plateau fractures, or a specialized patellar view such as the 'sunrise' or 'Merchant' view to evaluate patellar subluxation or patellofemoral arthritis. Alternatively, a 'tunnel' or intercondylar notch view may be used to visualize loose bodies or osteochondritis dissecans within the notch. The final report generated by the radiologist or interpreting physician details the bone density, joint space width, presence of osteophytes, cortical integrity, and any soft tissue swelling. This procedure is fundamental in the workup of acute trauma, chronic degenerative disease, and postoperative monitoring of orthopedic hardware.
Clinical Indications
- Acute knee trauma with suspected fracture or dislocation
- Chronic knee pain and suspected osteoarthritis
- Evaluation of joint effusion or localized swelling
- Suspected patellar instability or tracking disorders
- Detection of radiopaque loose bodies in the joint space
- Assessment of tibial plateau or distal femur fractures
- Monitoring of healing in known fractures
- Evaluation of prosthetic joint alignment or hardware failure
- Pre-operative planning for total knee arthroplasty
- Clinical suspicion of osteomyelitis or bony neoplasms
Procedure Steps
- Confirm patient identity and the specific side (right, left, or bilateral) to be imaged.
- Position the patient for the Anteroposterior (AP) view, typically supine or standing for weight-bearing assessment.
- Align the X-ray beam perpendicular to the long axis of the femur and tibia, centered at the lower pole of the patella.
- Reposition the patient for the Lateral view, usually in a side-lying position with the knee flexed 20-30 degrees.
- Perform the third specialized view, such as an internal or external oblique view, or a sunrise/tangential view of the patella.
- Apply appropriate lead shielding to protect the patient from unnecessary radiation exposure to the pelvic region.
- Capture the digital or film-based images ensuring clear visualization of the joint margins and cortical borders.
- Review images for technical adequacy, ensuring no motion blur and proper exposure.
- Release the patient and transmit images for professional interpretation by a radiologist or orthopedic surgeon.
Coding Guidelines
- Report 73562 only when exactly three views of a single knee are performed.
- For one or two views, use CPT code 73560.
- For four or more views, use CPT code 73564.
- Append modifier -RT (Right) or -LT (Left) to specify the side being examined.
- If bilateral three-view knee X-rays are performed, report 73562 with modifier -50 or report 73562-RT and 73562-LT depending on individual payer requirements.
- If only the professional component is provided, append modifier -26. If only the technical component is provided, append modifier -TC.
- Weight-bearing views do not change the code selection; the code is determined solely by the number of views.
- Do not report 73562 in conjunction with 73560 or 73564 for the same knee on the same date of service.