Radiology Coding Alert

All the cervical spine bases are covered for any number of views.

The confusion of identifying oblique, flexion, and extension cervical views for 72052 has been eliminated in CPT® 2013. The definitions for cervical X-ray codes 72040 and 72050 have been revised, too. Here are the details.

72040: Note the Change to ‘3 Views or Less’

The goal of changing the code definitions was to "more clearly define the services performed" and "more clearly reflect current clinical practice," explained Richard Duszak, MD, FACR, member of the CPT® Editorial Panel, in his presentation "Radiology Changes 2013" at the AMA’s CPT® and RBRVS Annual Symposium.

The first code in the cervical spine X-ray series is 72040. In 2012, 72040 was appropriate for "2 or 3 views." In 2013, the code is appropriate for "3 views or less":

• 2012: 72040, Radiologic examination, spine, cervical; 2 or 3 views
• 2013: 72040, Radiologic examination, spine, cervical; 3 views or less.

Based on the new definition’s wording, 72040 is now appropriate for a single cervical view, two views, or three views. In 2012, 72040 was not appropriate for a single cervical view because the definition specified two or three views.

72050: Limit This Code to 4 or 5 Views

The next code in the cervical X-ray range is 72050. For 2013 dates of service, the code is specific to "4 or 5 views." In 2012, the code definition required a "minimum of 4 views," meaning four views or more:

• 2012: 72050, Radiologic examination, spine, cervical; minimum of 4 views
• 2013: 72050, Radiologic examination, spine, cervical; 4 or 5 views.

The 2013 definition makes it clear that you should report the code when four or five views were performed. This helps resolve confusion caused by the 2012 code definition. The 2012 reference to "minimum of 4 views" left many coders unsure about when to use 72050 rather than the vaguely defined "complete" code, 72052, described below.

72052: ‘Complete’ Swaps Places With ‘6 or More’

The final code in the series is 72052. The 2013 definition has a streamlined requirement of "6 or more views." In 2012, the definition was less clear, referring to a "complete" exam and certain views:

• 2012: 72052, Radiologic examination, spine, cervical; complete, including oblique and flexion and/or extension studies
• 2013: 72052, Radiologic examination, spine, cervical; 6 or more views.

The 2012 definition, with its use of "and" and "and/or," often raised questions about precisely which views were required and which were optional. To simplify, 72052 use now depends on the number of views rather than the type of views.

Tackle Changes With a Simple Table

To summarize proper use of the cervical spine X-ray codes in 2013, Duszak suggests thinking of the codes in these terms:

Remember: These revisions are effective for services performed on or after Jan. 1, 2013.