71045

Radiologic examination, chest; single view, frontal

CPT code 71045 describes a radiologic examination of the chest consisting of a single radiographic view, specifically a frontal projection (e.g., PA or AP view). This procedure involves capturing an X-ray image of the thoracic cavity, including the lungs, heart, mediastinum, diaphragm, and bony thorax, from a front-to-back or back-to-front perspective. It is a fundamental diagnostic tool used to visualize the structures within the chest for the detection of various pulmonary, cardiac, and skeletal abnormalities.

Clinical Indications

  • Evaluation of acute or chronic cough
  • Assessment of dyspnea or shortness of breath
  • Investigation of chest pain of pulmonary or cardiac origin
  • Detection or monitoring of pneumonia, bronchitis, or other respiratory infections
  • Screening for tuberculosis (TB) in high-risk individuals or as part of occupational health protocols
  • Follow-up of known pulmonary nodules, masses, or interstitial lung disease
  • Evaluation of pleural effusion or pneumothorax
  • Pre-operative assessment for certain surgical procedures
  • Evaluation of trauma to the chest wall or thorax
  • Assessment of heart size and configuration (cardiomegaly)

Procedure Steps

  1. Patient identification and verification of ordered examination.
  2. Patient is positioned either standing, sitting, or supine, with appropriate shielding for radiation protection.
  3. For a PA (posteroanterior) view, the patient stands facing the detector, with shoulders rotated forward and down to move the scapulae out of the lung fields, and hands on hips. A full inspiration is typically requested.
  4. For an AP (anteroposterior) view, the patient typically lies supine or sits, with the X-ray tube positioned anteriorly.
  5. The X-ray tube is centered to the mid-sternum at the level of T7, ensuring proper collimation.
  6. Exposure parameters (kVp, mAs) are selected based on patient size and desired image quality.
  7. X-ray exposure is initiated to capture the single frontal image.
  8. Image processing and quality assurance checks are performed to ensure diagnostic acceptability.
  9. Images are sent to the radiologist for interpretation.

Coding Guidelines

  • CPT code 71045 represents the professional and technical components of a single frontal view chest X-ray.
  • When only a single frontal view is performed, use 71045. Do not use 71046 (chest X-ray, 2 views) if only one view is taken.
  • If a frontal view is performed along with another view (e.g., lateral view), code 71046 should be reported, which includes both frontal and lateral views.
  • This code includes the image acquisition, technical preparation, and the professional interpretation and report by a physician.
  • Documentation must clearly specify that only a single frontal view was obtained and the medical necessity for that specific view.
  • Radiology codes are subject to the global period concept for minor procedures, though this typically applies more to surgical procedures. For diagnostic radiology, the global period generally refers to the services included in the interpretation and report.
  • Modifier 26 (Professional Component) should be appended if only the radiologist's interpretation and report are being billed (e.g., when the hospital or facility bills for the technical component).
  • Modifier TC (Technical Component) should be appended if only the technical component (e.g., equipment, supplies, technologist services) is being billed.

Associated ICD-10 Codes