Radiology Coding Alert

Question: If our radiologist performs three single cervical views, may I report CPT 72020 and add modifiers to the second and third, or do I have to use 72040?

Wisconsin Subscriber

Answer: The solution to this problem depends on what you mean by "three single views."
 
If the three repeated views are all obtained as one examination, the three single views are the same as "three views." In this case, your best bet is 72040 (Radiologic examination, spine, cervical; two or three views).
 
Code 72020 (Radiologic examination, spine, single view, specify level) represents one view of the spine - any level. Code 72040 exists specifically for two or three views of the cervical spine. The standard exam includes AP (anteroposterior), lateral, and open mouth odontoid views.
 
Consider this: Many payers bundle 72020 into more comprehensive spinal x-ray codes, so don't try to report 72020 with 72040.
 
Another way: If the physician repeats the three single views as serial examinations (perhaps during the stabilization of a cervical fracture or dislocation or as localizing views during cervical disc surgery), the correct strategy is to code each as a separate single-view examination and provide documentation to ensure that they are not rejected as duplicate bills.
 
How to do it: Report 72020, 72020-76 (Repeat procedure by same physician), 72020-76-59 (Distinct procedural service).