CPT Code for Chest X-ray with Frontal and Lateral Views
The correct CPT code for a chest x-ray with both frontal and lateral views is 71046, which represents a diagnostic radiologic examination of the chest with 2 views. 1
Understanding CPT Code Selection for Chest X-rays
The CPT code selection for chest radiography is based on the number of views performed, not the diagnostic outcome or clinical utility of the results:
- 71045: Chest X-ray, single view
- 71046: Chest X-ray, 2 views (frontal and lateral)
- 71047: Chest X-ray, 3 views
- 71048: Chest X-ray, 4 or more views
In this case, since both frontal and lateral views were performed, regardless of the inconclusive results, the appropriate code is 71046.
Rationale for Code Selection
The American College of Radiology (ACR) guidelines clearly indicate that a standard chest x-ray with frontal and lateral views is considered a 2-view examination 1. This coding is determined by:
- The actual procedure performed (2 distinct views)
- The standard radiographic protocol for chest evaluation
- The technical components of the study
Common Coding Errors to Avoid
When coding chest x-rays, be aware of these potential pitfalls:
- Confusing the number of views with the number of images
- Allowing the diagnostic outcome (inconclusive results) to influence code selection
- Failing to recognize that frontal and lateral views together constitute a 2-view study
- Using outdated CPT codes that may have been revised
Clinical Context
For a 62-year-old male presenting with shortness of breath, a chest x-ray with both frontal and lateral views is an appropriate initial diagnostic approach. The ACR Appropriateness Criteria rates chest x-ray as highly appropriate (9/9) for initial evaluation of shortness of breath 1. This approach allows for comprehensive assessment of:
- Cardiac size and contour
- Pulmonary fields
- Mediastinal structures
- Thoracic cage
Even though the results were inconclusive in this case, the code selection is based on the procedure performed, not the diagnostic outcome.