AMA Clinical Examples in Radiology - 2018 Issue 3 (Summer)
X-ray Left Foot and Calcaneus
CLINICAL EXAMPLE 2 X-ray Left Foot and Calcaneus CLINICAL DATA A 52-year-old male presents with swelling and pain of the left foot and heel. There is no known injury. PROCEDURE 73630 Anteroposterior, lateral, and oblique views of the left foot and lateral and orthogonal views of the left heel were performed. FINDINGS There is soft tissue swelling adjacent to the fifth metatarsal head. No acute fracture or dislocation is seen. No focal osseous lesion is seen. No radiopaque foreign body or soft tissue gas is identified. No bony erosion is seen. Plantar arch is maintained. Subtalar joints appear normal...
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Article Overview
This premium article explains coding considerations for a left foot and calcaneus X-ray case. It is useful for radiology coders, billers, and compliance staff who need to understand the relationship between CPT imaging codes, ICD-10-CM diagnosis reporting, and Medicare NCCI guidance, along with the CMS transmittals and modifiers discussed in the context of X-ray reimbursement and claims processing.
Why This Topic Matters
Foot and calcaneus imaging can involve overlapping anatomic coverage, payer edits, and modality-specific modifier reporting. Understanding the article helps support accurate claim submission, avoid edit-related denials, and align documentation with Medicare and payer expectations.
Article Sections
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Clinical Example 2
Introduces the imaging scenario and patient presentation that frames the coding discussion.
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Procedure
Summarizes the X-ray study performed for the foot and heel.
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Findings
Describes the imaging observations and radiographic impressions reported in the case.
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Impression
Provides the overall radiology interpretation for the study.
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How to Code
Presents the coding summary for the encounter, including the imaging code and associated diagnosis codes.
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Discussion
Reviews broader coding and billing considerations related to foot and calcaneus X-ray reporting, including Medicare edit guidance and modifier usage concepts.
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Sources
Lists reference materials and CMS resources used to support the article.
What You Will Learn
- How a foot and calcaneus X-ray case is summarized for coding purposes
- What general coding topics are discussed for radiology imaging claims
- How Medicare NCCI and CMS transmittals are addressed in the article
- Which broad types of diagnosis and modifier reporting issues are associated with this scenario
Who Should Read This
- Radiology coders
- Medical billers
- Compliance staff
- Revenue cycle specialists
- Physician practice staff
Codes Discussed
Modifiers Discussed
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