Summary & Overview
CPT 71111: Four-View Radiological Study of Ribs, Including PA Chest
CPT code 71111 represents a diagnostic radiological study of the ribs using at least four views, including a posteroanterior chest view. This imaging service is commonly used to identify rib fractures, assess trauma-related injuries, and evaluate other rib or chest wall abnormalities. Nationally, rib radiographs are an important low-cost imaging option for initial assessment of thoracic trauma and musculoskeletal complaints, often serving as a first-line modality before advanced imaging.
Key payers in the national landscape include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Coverage policies vary by payer regarding medical necessity criteria, documentation requirements, and bundling with chest radiography or other imaging studies.
Readers will find concise clinical context for when CPT code 71111 is used, typical sites of service, and common operational considerations. The publication also provides benchmarking context, payer coverage highlights, and policy update summaries relevant to imaging utilization and billing practices. This overview supports facility administrators, radiology managers, and billing professionals seeking clear guidance on coding and payer expectations for rib radiography.
Billing Code Overview
CPT code 71111 describes a radiological diagnostic study of the ribs consisting of a minimum of four views, including a posteroanterior (PA) chest view. The procedure is performed to evaluate rib pathology such as fractures, contusions, or other structural abnormalities.
-
Service type: Diagnostic radiology study
-
Typical site of service: Outpatient radiology departments, hospital radiology suites, urgent care centers, and emergency departments
Clinical & Coding Specifications
Clinical Context
A 45-year-old male presents to the emergency department after a fall from a ladder with localized left-sided chest pain and focal tenderness along the lateral ribcage. On exam he has point tenderness over the left ribs and pain with deep inspiration. The emergency physician orders a limited rib radiographic series to evaluate for rib fracture and to screen for associated complications. The radiology technologist obtains a minimum of four views including dedicated rib views and a posteroanterior chest radiograph. Images are interpreted by a radiologist with findings documented in the imaging report. The study is performed in an outpatient radiology department or hospital radiology suite; results guide pain management, activity restrictions, and potential follow-up imaging if complications are suspected.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
25 | Significant, separately identifiable evaluation and management service by the same physician on the same day of the procedure | When an unrelated E/M is performed and documented the same day as the rib radiographs |
26 | Professional component | When billing only the interpreting physician’s professional component for the radiology service |