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What is the number of views in the CBHPM used for?
Understand what the number of views column in Chapter 4 of the CBHPM is, how it guides the composition of imaging tests and why applying it correctly prevents denials in hospital billing
- By
- Rivio, Editorial team
- Published
- Reading time
- 5 minutes
The “Number of Views” (Número de Incidências) column is one of the fields that raises the most questions among billing specialists who work with Chapter 4 of the CBHPM (the one dedicated to radiology and diagnostic imaging tests). Understanding what it is for and how to apply it correctly makes a direct difference to billing quality and denial prevention.
What the number of views in the CBHPM is
Present in the procedures of Chapter 4 of the Brazilian Hierarchical Classification of Medical Procedures (CBHPM), the “Number of Views” column indicates the number of projections or sides used to perform an imaging test. In radiology, a view corresponds to each position or angle at which the X-rays strike the patient to produce an image.
This information does not enter directly into the calculation of the procedure’s value. The tier, operating cost and film values are already set in the table according to the maximum number of views each test can have. The column exists to guide the technical composition of the procedure and to ensure that the charge correctly reflects the complexity of the test performed.
How the number of views defines the procedure
In the CBHPM, radiology procedures with different numbers of views are registered as distinct codes. This means that a chest X-ray taken in a single projection has a different code from the same test taken in two or four projections (and, consequently, different values).
A good example is the chest X-ray, which in the CBHPM can range from 1 to 4 views:
| CBHPM code | Description | Views |
|---|---|---|
| 40805018 | X-ray — Chest | 1 view (PA) |
| 40805026 | X-ray — Chest | 2 views (PA + lateral) |
| 40805034 | X-ray — Chest | 3 views |
| 40805042 | X-ray — Chest | 4 views |
In the 1-view procedure (code 40805018), the test is performed in the posteroanterior (PA) projection: the X-rays enter through the patient’s back, with the detector positioned in front of the chest. Each additional view corresponds to a new projection (such as the lateral, the oblique or the apical, which adds diagnostic information and justifies the higher‑value code.
As the number of views increases, the value of the procedure is adjusted in the table, reflecting the greater use of technical, operational and film resources.
Why the number of views affects billing
Billing the wrong code for the number of views performed is one of the most common causes of denials on imaging test claims. Two errors come up frequently:
Billing more views than were performed
If the report or the medical order records only one projection and billing uses the two-view code, the payer has grounds to deny the difference. The test documentation must support the code billed.
Billing fewer views than were performed
The hospital performs two projections but bills only the one-view code. The amount charged falls below what would be due, which means an avoidable loss of revenue. This type of error is especially common when clinical documentation and billing are not integrated.
In both cases, the problem originates in the disconnect between what was performed, what was recorded in the medical record and what was billed. A well-structured concurrent audit process identifies these inconsistencies before the claim is sent to the payer.
Number of views and other Chapter 4 fields
The number of views is one of the specific fields in Chapter 4, but not the only one that requires attention when billing imaging tests. Other elements that make up the final value of a radiology procedure in the CBHPM include the tier, the operating cost and the film value, the latter calculated in square meters based on the reference value of the CBR (Brazilian College of Radiology), updated annually.
The correct combination of these elements, with the code that exactly reflects the test performed and its views, ensures that the claim reaches the payer without inconsistencies and without the risk of a denial for a technical discrepancy. To understand how structured hospital billing protects the hospital’s revenue cycle, see the complete guide on the subject.
Frequently asked questions about the number of views in the CBHPM
What is the number of views in the CBHPM?
It is the column present in the procedures of Chapter 4 of the CBHPM that indicates the number of projections or sides used to perform an imaging test. This information guides the technical composition of the procedure and defines which code should be used in billing.
Does the number of views enter into the calculation of the procedure’s value?
Not directly. The tier, operating cost and film values are already set in the table according to the maximum number of views for each test. The number of views determines which code should be used. Each code has its own value.
What happens if the number of views billed differs from the number performed?
If the number billed is higher than the number performed, the payer may deny the difference for lack of documentary support. If it is lower, the hospital will lose revenue by charging below the amount due. In both cases, the error originates in the disconnect between clinical documentation and billing.
Which tests does Chapter 4 of the CBHPM apply to?
Chapter 4 covers clinical pathology, anatomic pathology and radiology and diagnostic imaging tests. The number of views column is specific to conventional radiology procedures, in which each projection corresponds to one view.
How can denials related to the number of views be avoided?
By making sure the code billed matches exactly the number of views recorded in the report and the medical order. Auditing claims before submission (checking the consistency between the medical record, the report and billing) is the most efficient way to prevent this type of denial.
