Q/A: Do Digital X-rays Have Their Own Codes?

February 7th, 2019 - Wyn Staheli, Director of Research
Categories:   CPT® Coding   Modifiers  
0 Votes - Sign in to vote or comment.

Question

Are you aware if digital x-ray of the spine requires a different code than plain x-ray?  If so, where can I find the information specific to digital x-ray codes?

Answer

There are no separate codes for digital x-rays. However, there may be modifiers that are required to be submitted with the usual imaging codes. The Consolidated Appropriations Act of 2016, titled "Medicare Payment Incentive for the Transition from Traditional X-Ray Imaging to Digital Radiography and Other Medicare Imaging Payment Provision" makes it clear that Medicare wants providers to use digital imaging and like EHR, they will penalize you for not using the newer technology.

Effective January 1, 2017, Medicare requires modifier FX if the image is done with film. This modifier reduces payment of the technical component (and the technical component of the global fee) by 20 percent. It is important to note that this reduction ONLY applies to the technical component. This fee reduction can not be passed on to the beneficiary.

Effective January 1, 2018, Medicare also began to require modifier FY when the image utilizes computed radiography technology which Medicare defines as "cassette-based imaging which utilizes an imaging plate to create the image involved." This modifier reduces the payment by 7% until 2023 when it increases to 10 percent reduction.

Note: If an imaging service has both computed radiography (CR) technology and images taken using digital radiography (DR) views, then there will be no payment reduction.

Other Payers

Even though Medicare does not cover imaging taken by doctors of chiropractic, it is apparent that some other payers are also beginning to require these new modifiers. For example, Aetna’s March 2017 newsletter states that they require modifier FX as of June 1, 2017. Moda Health seems to be following suit. Another payer policy that we found stated that although they require modifier FX now, they would not be reducing payment, but that policy was dated March 2017 so they may have updated their policy since that time.

Bottom line is that regardless of payer, we are recommending that you use these new modifiers on every applicable claim. Please note that “accidentally forgetting” to include them does not exclude you and future payer audits will require you to pay back the insurance amounts incorrectly paid.

###

Questions, comments?

If you have questions or comments about this article please contact us.  Comments that provide additional related information may be added here by our Editors.


Latest articles:  (any category)

A 2020 Radiology Coding Change You Need To Know
February 10th, 2020 - Aimee Wilcox, CPMA, CCS-P, CST, MA, MT, Director of Content
The radiology section of the 2020 CPT© has 1 new, 18 revised, and 14 deleted codes. Interestingly, six of the 14 deleted codes were specific to reporting single-photon computerized tomographic (SPECT) imaging services of the brain, heart, liver, bladder, and others. If your organization reports radiology services, it is...
Documenting telephone calls at your dental practice is just as important as documenting patient visits.
February 4th, 2020 - Christine Taxin
Documenting telephone calls at your dental practice is just as important as documenting patient visits. Similar to other documentation, the common rule when it comes to call documentation is that if it is not documented, it did not happen. Therefore, every clinically relevant telephone call should be documented. Clinically relevant calls ...
CPT 10-Year Historical Content - Now Available!
January 22nd, 2020 - Find-A-Code
Did You Know? We now offer Historical CPT Content in 2-year, 5-year, or 10-year options! Utilize access to specific CPT historical data for previous years using rules effective at that specific time. If you’ve added UCR fees to your account, you can use Historical CPT Content to view UCR fees from ...
Inadequate Exclusion Screenings Could Put Your Practice at Risk
January 21st, 2020 - Wyn Staheli, Director of Research
Exclusion screenings require far more than just checking a name on a federal database at the time you are hiring someone. Far too many providers don’t realize that in order to meet compliance requirements, there is MUCH more involved. There are actually over 40 exclusion screening databases/lists that need to be checked.
Q/A: How do we Bill Massage Services?
January 21st, 2020 - Wyn Staheli, Director of Research
Question: We are adding a massage therapist soon and have some questions about billing their services.
Billing for Telemedicine in Chiropractic
January 14th, 2020 - Evan M. Gwilliam DC MBA BS CPC CCPC QCC CPC-I MCS-P CPMA CMHP
Many large private payers recognize the potential cost savings and improved health outcomes that telemedicine can help achieve, therefore they are often willing to cover it. While there are several considerations, there could be certain circumstances where telemedicine might apply to chiropractic care.
Non-Surgical Periodontal Treatment
January 14th, 2020 - Christine Taxin
AAP treatment guidelines stress that periodontal health should be achieved in the least invasive and most cost-effective manner. This is often accomplished through non-surgical periodontal treatment.Non-surgical periodontal treatment does have its limitations. When it does not achieve periodontal health, surgery may be indicated to restore periodontal health.SCALING AND ROOT PLANINGScaling ...



About Codapedia by innoviHealth® Contact Us Terms of Use Privacy Policy Advertise with Us

innoviHealth® - 62 E 300 North, Spanish Fork, UT 84660 - Phone 801-770-4203 (9-5 Mountain)

Copyright © 2000-2020 innoviHealth Systems®, Inc. - CPT® copyright American Medical Association