X-ray exam chest 2 views
CPT code 71046 covers a standard chest X-ray taken from two different angles (typically front and side views). This is one of the most common diagnostic imaging tests used to evaluate the lungs, heart, and chest wall.
RVU breakdown
Conversion factor: 32.3465 · Source: CMS MPFS RVU25A · Confidence: High
Billing tips
Verify that exactly two views were obtained before coding 71046; if only one view was taken, use 71045 instead
Impact: Prevents downcoding and claim denials; 71046 requires documentation of two distinct projections in the radiology report
Split bill with modifier 26 and TC when professional and technical services are provided by different entities
Impact: Ensures proper payment distribution; combined 26+TC should equal the global fee of $32.67
Document medical necessity with specific clinical indication (ICD-10 code) - avoid vague diagnoses like 'screening' for Medicare patients
Impact: Prevents denials for lack of medical necessity; specific diagnoses like pneumonia, dyspnea, or chest pain support coverage
Do not bill 71046 with 71047 or 71048 on the same date of service for the same anatomical area
Impact: Prevents bundling denials; these codes are mutually exclusive and will result in automatic claim rejection
Ensure radiologist interpretation report includes all required elements: technique, findings, impression, and date/time
Impact: Incomplete reports trigger audit flags and potential payment recoupment; complete documentation protects $32.67 reimbursement
For facility billing, verify place of service code matches the actual location (hospital outpatient vs. independent facility)
Impact: Incorrect POS codes can trigger audits; both facility and non-facility rates are $32.67 for this code, but accurate reporting is essential for compliance
Common denials
Medical necessity not established - denial for routine screening without documented symptoms or risk factors
How to appeal: Submit clinical notes demonstrating symptoms (cough, dyspnea, fever) or relevant history; include reference to Medicare LCD policy for chest X-ray indications; provide supporting documentation from ordering physician
Frequency limitation exceeded - multiple chest X-rays within short time period without justification
How to appeal: Document clinical change or acute deterioration requiring repeat imaging; provide comparison readings showing disease progression; use modifier 76 with detailed explanation of medical necessity
Bundled/component of another service - denied when billed with comprehensive E/M or other imaging on same date
How to appeal: Demonstrate that X-ray was separately identifiable and medically necessary; if part of distinct clinical encounter, append modifier 59 and provide documentation showing separate decision-making
Incorrect number of views documented - claim coded as 71046 but report describes only single view
How to appeal: Review actual images taken and radiologist report; if two views were performed, request corrected radiology report documenting both projections; if only one view taken, accept corrected code 71045 and resubmit
Frequently asked questions
What is the Medicare reimbursement rate for CPT 71046 in 2025?
The 2025 Medicare national average reimbursement for CPT 71046 is $32.67 for both facility and non-facility settings. This is based on 1.01 total RVUs multiplied by the 2025 conversion factor of 32.3465.
What is the difference between CPT 71045 and 71046?
CPT 71045 is a chest X-ray with a single view (one projection), while CPT 71046 requires two views (typically PA and lateral). The two-view exam provides more comprehensive diagnostic information and has higher reimbursement. Always code based on the actual number of views documented.
Can I bill CPT 71046 for a routine pre-employment physical?
Medicare does not cover routine screening chest X-rays for pre-employment or general health screenings without documented symptoms or specific medical indications. For non-Medicare patients, coverage depends on the individual insurance policy. Use modifier GY when billing non-covered services to Medicare.
How many RVUs is CPT code 71046 worth?
CPT 71046 has a total of 1.01 RVUs for 2025, consisting of 0.22 work RVUs, 0.77 practice expense RVUs (both facility and non-facility), and 0.02 malpractice RVUs.
Do I need modifier 26 when billing 71046?
Use modifier 26 only when billing for the professional component (physician interpretation) separately from the technical component. If you're billing the complete service (global), do not use modifier 26. Split billing typically occurs when a radiologist reads films taken at a different facility.
What diagnosis codes are typically used with CPT 71046?
Common ICD-10 codes include R05.9 (cough), R06.02 (shortness of breath), R07.9 (chest pain), J18.9 (pneumonia), Z87.891 (history of tobacco use), and J44.9 (COPD). The diagnosis must support medical necessity for the imaging study.
Can CPT 71046 and 71047 be billed together on the same day?
No, CPT 71046 (2 views), 71047 (3 views), and 71048 (4+ views) are mutually exclusive codes for the same anatomical area. Bill only the code that matches the total number of views actually performed and documented. Billing multiple codes will result in denial.