Current Procedural Terminology (CPT) codes provide a standardized language for documenting medical services and procedures. Maintained by the American Medical Association (AMA), this system is used by healthcare providers and insurers for billing and record-keeping. Every medical procedure has a unique CPT code, ensuring consistency across all settings. CPT code 71046 identifies a common diagnostic procedure: the two-view chest X-ray.
Defining CPT Code 71046
CPT code 71046 is defined as: “Radiologic examination, chest; two views.” This code is used when two distinct X-ray images are captured for a comprehensive assessment of the thoracic cavity. The two views typically consist of a Posteroanterior (PA) view (back to front) and a Lateral view (side).
The two-view study is the standard for initial chest imaging because it overcomes the limitations of a single X-ray. A single frontal view suffers from superimposition, where structures overlap and obscure abnormalities. The lateral view provides a side profile, offering better spatial orientation and helping to localize findings in three dimensions.
When this code is billed, it covers both the technical and professional components of the service. The technical component involves the physical performance of the test, including the use of the X-ray equipment, supplies, and the time of the radiologic technologist. The professional component accounts for the specialized interpretation of the images and the creation of a formal report by a qualified physician, such as a radiologist.
Clinical Applications of the Two-View Chest X-ray
The two-view chest X-ray is one of the most frequently ordered diagnostic imaging tests. Physicians rely on the combined PA and lateral images for superior diagnostic accuracy. This comprehensive assessment is often the first step in investigating symptoms like persistent cough, chest pain, or shortness of breath.
The procedure is highly effective in identifying infectious and inflammatory processes, such as pneumonia, by visualizing areas of consolidation or fluid in the lungs. It is also routinely used to assess the size and contour of the heart, which helps in the diagnosis of cardiomegaly, or an enlarged heart, and can show signs of congestive heart failure. The lateral view is particularly helpful in evaluating the heart’s posterior aspects and the structures behind it.
In cases of trauma, the two-view X-ray can quickly detect fractures of the ribs or sternum, as well as the presence of air outside the lungs, known as a pneumothorax. The lateral projection helps distinguish between anterior and posterior lesions that might be missed on a frontal view. The examination is also frequently used to confirm the correct placement of various medical devices, including central venous catheters, feeding tubes, and pacemakers.
Distinguishing 71046 from Related Chest X-ray Codes
The CPT code set for chest X-rays is structured based on the number of distinct views performed. This ensures the reported code accurately reflects the complexity and extent of the imaging study. CPT 71046 specifically covers the two views required for a standard comprehensive diagnostic evaluation.
The single-view chest X-ray is represented by CPT code 71045. This code is typically reserved for limited examinations, such as a quick follow-up to check the position of a previously placed tube or line, or for certain screening purposes. A single view offers less diagnostic information and may not be sufficient for a detailed initial assessment of a patient with new symptoms.
For studies requiring additional images, CPT code 71047 is used for three views, and CPT code 71048 is used for four or more views. These codes are necessary when the physician requires specialized projections beyond the standard PA and lateral, such as apical lordotic or oblique views. Accurate documentation of the exact number of views taken is necessary to select the correct CPT code.