CPT Code 71046: Chest X-Ray, Two Views (Frontal and Lateral)

What is CPT code 71046?

The 71046 CPT code description refers to a chest X-ray with two views—typically frontal (PA) and lateral—that helps evaluate the lungs, heart, ribs, and mediastinum. This is one of the most frequently used diagnostic tools in clinical settings, allowing healthcare providers to assess conditions like pneumonia, heart failure, pneumothorax, or lung nodules.

Unlike single-view codes, 71046 offers a broader diagnostic perspective and is commonly performed in emergency rooms, outpatient imaging centers, and hospitals. It is important to use the correct CPT code that aligns with the number of views captured.

Documentation requirements

Accurate documentation is essential for revenue cycle management and claim approval. Make sure the following elements are present in the medical record:

• Clinical indications: Clearly note symptoms or diagnoses supporting medical necessity, such as shortness of breath, chest pain, or trauma.
• Number and type of views performed: Specify that both frontal and lateral views were completed to justify the use of 71046 rather than a single-view code.
• Interpretation and report: A signed, dated interpretation from the reading provider must be included, satisfying the professional component.
• Link to ordering provider: Documentation must show the ordering clinician's name and reason for the test, especially for Medicare beneficiaries or Medicaid services compliance.

Billing guidelines

When it comes to accurate billing, consider these key coding guidelines:

• Do not report with other chest X-ray codes for the same patient: If only two views are done, CPT 71046 is the appropriate code. Avoid using 71045 (one view) or 71047 (three+ views) unless the exam warrants it and is documented.
• Bill technical and professional components appropriately: Use modifier 26 for the professional component and modifier TC for the technical component, or bill globally if both were performed by the same provider.
• Follow Medicare guidelines: Medicare administrative contractors (MACs) may have local coverage determinations (LCDs) that define acceptable ICD-10 codes to support medical necessity. Always verify with the payer to process claims correctly.
• Ensure accurate reimbursement: Submitting claims with incomplete or inaccurate documentation can delay payment. Make sure to accurately represent the service provided.
• Repeat studies on same day: If another chest X-ray is necessary for the same patient on the same day, include documentation explaining the new clinical indication and consider using modifier 76.

Other relevant CPT codes

• 71045: Chest X-ray, one view
• 74022: Radiologic examination, complete acute abdomen series, multiple views of abdomen,  single view chest
• 71048: Chest radiologic examination with four or more views