Radiology Coding Alert

Question: A patient presented to our radiology practice with low back pain. The patient’s primary care physician (PCP) ordered X-rays of the patient’s lumbosacral spine. The radiology report lists the views as anteroposterior (AP), lateral, coned-down lateral, left and right oblique, and flexion lateral.

When choosing the correct code to assign, are all the lateral views considered the same view or are they different views?

Montana Subscriber

Answer: The radiologist listed six different views in the report, which includes three different lateral views. Your question indicated the radiologist captured a traditional lateral view, a coned-down lateral view, and a flexion lateral view. Since the radiologist needed to either adjust the equipment or reposition the patient for those views, the lateral views are considered different views.

A lateral view is a side-to-side view of the patient’s spine. When a radiologist performs a coned-down view, they focus a beam of X-rays on a specific area to capture a more detailed image. Lastly, the flexion-extension lateral view is when the patient is either bending forward (flexing) or standing up (extension).

This means you’ll assign 72114 (Radiologic examination, spine, lumbosacral; complete, including bending views, minimum of 6 views) to report the procedure. Plus, when you look at the descriptor, you’ll notice 72114 includes bending views, which is the flexion view included in the radiology report.