Orthopedic Coding Alert

Question: We performed a four-view x-ray of the spine including flexion and extension views. Because we performed a bending view, our office manager wants to report 72114. Is this accurate?

Arkansas Subscriber

Answer: Just because the descriptor for 72114 (Radiologic examination, spine, lumbosacral; complete, including bending views) includes "bending views," you don't necessarily have to report this code when you perform bending views of the spine. Most carriers define a "complete, including bending views" series (72114) as including anterioposterior, lateral and both oblique views, as well as flexion and extension views. Your question does not indicate that you performed all these views.
 
It sounds as if you should instead report either 72110 (Radiologic examination, spine, lumbosacral; minimum of four views) or 72120 (Radiologic examination, spine, lumbosacral, bending views only, minimum of four views). Although the descriptor for 72110 does not refer to bending views, the local medical review policy for Blue Cross and Blue Shield of Arkansas (a Part B carrier) states, "Codes 72110 and 72114 include oblique and/or bending views."
 
The code refers to a minimum of four views, and because you performed four, 72110 might best describe your service. If the four views that you obtained were limited to bending views only, code 72120 would more accurately represent the service.