Coding for three views of the lower leg

Q.

We occasionally perform three views for x-raying the lower leg (i.e., tibia-fibula). The code description is for only two views. How do we report three views?  

A.

Think of the code description for CPT^® 73590 as “minimum of” two views and roll the third view into that.  The American Medical Association (AMA) appears to consider 73590 “minimum of” as well. Here’s part of an answer to a question in CPT Assistant in November 2017: “If radiological examinations of the tibia/fibula (minimum of 2 views) and femur (minimum of 2 views) are medically indicated (explicitly documented), ordered, and acquired images adequately depict the anatomy in both regions, the service should be reported separately with codes 73552 and 73590.”  The code and complete description are:

73590 Radiologic examination; tibia and fibula, 2 views