Radiologic examination, chest; 2 views, frontal and lateral
Audit Defense & Denial Intelligence
Research-based denial patterns from OrbDoc Bill Analyzer
1. Should bill 71010 instead - lateral view not medically necessary
Common71020 (chest X-ray 2 views) requires medical necessity for lateral view beyond frontal. Payers may downgrade to 71010 if lateral view not justified. Lateral view appropriate for pneumonia confirmation, mass localization, but not routine screening.
Common Causes
- • Lateral view ordered routinely without specific clinical indication
- • Simple cough or URI - frontal view sufficient
- • Pre-operative clearance where single view adequate
Resolution Strategy
Appeal with specific clinical indication requiring lateral view (suspected pneumonia needing localization, mass on prior imaging, detailed cardiac silhouette assessment). If simple symptoms where frontal view sufficient, downgrade to 71010 typically upheld.
💬 Plain Language Explanation
What this means
This is a chest X-ray - an imaging test that takes pictures of your chest, including your heart and lungs.
Why you might see this
This is a very common imaging test. Your doctor likely ordered this to check your heart or lungs, often done when you have chest symptoms, breathing problems, or to screen for certain conditions.
Common context
Very common imaging test, often used for chest symptoms, breathing problems, or routine screening.
What to ask your provider
"'What did the chest X-ray show? Were there any abnormalities?'"
Relative Value Units (RVUs)
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Clinical Information
When to Use
For 2-view chest X-ray (frontal and lateral)
Common Scenarios
Documentation Requirements
- Indication for chest X-ray
- 2 views (frontal and lateral)
- Findings and interpretation
- Comparison to prior studies if available
- Report documentation
Coding Guidelines
Common Modifiers
Bundling Rules
- Includes 2 views (frontal and lateral)
- Includes interpretation and report
- Single view coded separately
- Additional views coded separately
- Portable X-ray coded separately
Exclusions
- 71010 (chest X-ray, single view)
- 71030 (chest X-ray, complete minimum 4 views)
- 71045 (chest X-ray, single view, portable)
- 71046 (chest X-ray, 2 views, portable)
Coding Notes
Clinical scenarios
- Indication for chest X-ray
- 2 views (frontal and lateral)
- Findings and interpretation
- Indication for chest X-ray
- 2 views (frontal and lateral)
- Findings and interpretation
- Indication for chest X-ray
- 2 views (frontal and lateral)
- Findings and interpretation
Who are you?
Code Details
Medicare Pricing
Pricing data not available for this code.
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Ask a QuestionFrequently Asked Questions
CPT 71020 is the billing code for "Radiologic examination, chest; 2 views, frontal and lateral". For 2-view chest X-ray (frontal and lateral)
CPT 71020 has a total RVU of 2.30, broken down as: Work RVU 0.45, Practice Expense RVU 1.80, and Malpractice RVU 0.05. RVUs (Relative Value Units) determine Medicare reimbursement rates.
The most common denial reason for CPT 71020 is "Should bill 71010 instead - lateral view not medically necessary". 71020 (chest X-ray 2 views) requires medical necessity for lateral view beyond frontal. Payers may downgrade to 71010 if lateral view not justified. Lateral view appropriate for pneumonia confirmation, mass localization, but not routine screening. Common causes include: Lateral view ordered routinely without specific clinical indication; Simple cough or URI - frontal view sufficient. Appeal success rate is approximately 40-60%.
Key documentation requirements for CPT 71020 include: Indication for chest X-ray; 2 views (frontal and lateral); Findings and interpretation; Comparison to prior studies if available. Missing or incomplete documentation is a leading cause of claim denials for this code.
Bundling considerations for CPT 71020: Includes 2 views (frontal and lateral). Includes interpretation and report Use an NCCI bundling checker to verify specific code combinations before billing.
Common modifiers for CPT 71020 include: 26 (Professional component only (interpretation)), TC (Technical component only (equipment/staff)), 59 (Distinct procedural service if performed separately). Modifiers indicate special circumstances and can affect reimbursement or prevent claim denials.
The typical time requirement for CPT 71020 is 8-12 minutes typical procedure time. Time-based codes require documentation of the actual time spent providing the service.