71046

Radiologic examination, chest; 2 views

CPT code 71046 describes a radiologic examination of the chest, performed with two distinct radiographic views. Typically, these views include a posteroanterior (PA) view and a lateral view, which together provide comprehensive visualization of the lungs, heart, mediastinum, bony thorax, and diaphragm. This examination is a fundamental diagnostic tool used to assess a wide range of cardiopulmonary conditions, detect abnormalities, and monitor disease progression. The images are acquired using ionizing radiation and are subsequently interpreted by a qualified physician, such as a radiologist.

Clinical Indications

  • Evaluation of acute or chronic cough
  • Assessment of dyspnea or shortness of breath
  • Suspected pneumonia, bronchitis, or other respiratory infections
  • Evaluation of chest pain of suspected pulmonary or cardiac origin
  • Detection of pulmonary nodules, masses, or tumors
  • Assessment of pleural effusion or pneumothorax
  • Screening for tuberculosis (in specific high-risk populations)
  • Pre-operative assessment for certain surgical procedures
  • Monitoring of known pulmonary diseases (e.g., COPD, asthma, sarcoidosis)
  • Evaluation of trauma to the chest wall or thorax
  • Assessment of foreign body aspiration
  • Congestive heart failure evaluation and monitoring

Procedure Steps

  1. Patient identification and verification of the clinical indication.
  2. Patient is instructed to remove clothing, jewelry, or metallic objects from the waist up and to wear a gown.
  3. Positioning for the Posteroanterior (PA) view: Patient stands or sits facing the image receptor with shoulders rotated forward, arms at sides, and chin resting on the top of the image receptor; deep inspiration is instructed.
  4. Positioning for the Lateral view: Patient stands or sits with the left side against the image receptor, arms raised above the head, and deep inspiration is instructed.
  5. Appropriate collimation of the X-ray beam to the chest area.
  6. X-ray exposure is performed for each view.
  7. Image processing and quality control checks by the technologist.
  8. Images are sent to a Picture Archiving and Communication System (PACS) for interpretation.
  9. A qualified physician (e.g., radiologist) reviews and interprets the images, generating a diagnostic report.

Coding Guidelines

  • CPT code 71046 specifically designates a two-view chest X-ray. If fewer or more views are performed, different CPT codes (e.g., 71045 for 1 view, 71047 for 3 or more views) should be used.
  • This code includes both the technical component (TC) and the professional component (PC) when billed globally. If only the technical component (facility/equipment) or professional component (interpretation) is provided, appropriate modifiers (-TC or -26, respectively) should be appended.
  • A written report of the interpretation is required for reimbursement.
  • Supervision requirements for diagnostic radiology procedures typically require direct supervision for non-physician personnel performing the technical component.
  • Do not bill separately for fluoroscopy (76000) when it is used as a guidance for positioning during a standard chest X-ray, as it is typically included.
  • If a portable chest X-ray is performed, the same CPT code (71046) is used, but additional codes for transportation or setup may apply in specific settings (e.g., hospitals, nursing homes), but generally are not billable for standard inpatient settings.

Associated ICD-10 Codes