Radiology Coding Alert

Question: What, if anything, is the difference between a "swimmer's view" of the cervical spine and a plain one view (72020, C spine)? I have noticed this pattern with a particular radiology group: When they have an MVA patient, they do one view cervical spine and call it a swimmer's view, and then an additional x-ray is done that they call simply Spine One View - Cervical. Do you think there is a difference in the x-rays?

Maryland Subscriber

Answer: The main difference between the swimmer's view and other plain views is the way the technologist positions the patient to obtain all of the "C" spine vertebral bodies on the film. The swimmer's view is a lateral C spine film that is taken when you can't visualize the entire cervical spine with a regular cross-table lateral view. This may be needed, for example, for a patient who is immobilized on a backboard after an injury.

It is called the swimmer's view because you put the patient's arm up alongside the head, as if the patient were doing a backstroke. This position allows the radiologist to see the previously unevaluated portion of the C spine on a lateral projection.

You should still code for the total number of views that were taken. Therefore, if two views were obtained (e.g., swimmer's plus one more), the correct code would be 72040 (Radiologic examination, spine, cervical; two or three views). Don't code for the number of separate films that are used to obtain a single view; if two films are taken to obtain one lateral, it is still one view.

- Reader Questions and You Be the Coder were answered by Gary Dorfman, MD, FACR, SIR, president of Health Care Value Systems in North Kingstown, R.I.; and Cindy Parman, CPC, CPC-H, RCC, co-owner of Coding Strategies Inc., an Atlanta-based firm.