Radiology Coding Alert

Question: One of the radiologists in our practice performed X-rays of the patient’s thoracic, lumbar, and cervical spine. The provider captured anteroposterior (AP), lateral, and flexion views of the spine, and the skull was not imaged.

What CPT^® codes will we use to report this procedure?

Oregon Subscriber

Answer: You’ll assign only 72082 (Radiologic examination, spine, entire thoracic and lumbar, including skull, cervical and sacral spine if performed (eg, scoliosis evaluation); 2 or 3 views) to report this procedure. The provider captured three views of the spine, which didn’t include the skull.

The descriptor for 72082 states “including skull, cervical and sacral spine if performed.” The “if performed” is the key phrase that tells you to use this code regardless of whether the provider imaged any of the mentioned anatomical structures. In your case, the provider captured images of the cervical spine, but not the skull — in addition to the lumbar and thoracic spine.

Some coders might be tempted to assign three separate codes, such as 72050 (Radiologic examination, spine, cervical; 2 or 3 views), 72070 (Radiologic examination, spine, cervical; 2 or 3 views), and 72100 (Radiologic examination, spine, lumbosacral; 2 or 3 views), covering each section of the patient’s spine, but that is incorrect because the Radiology section of CPT^® contains combination codes that cover multiple spinal sections.

Each of the codes in the 72081-72084 range cover thoracic and lumbar X-ray views, along with the skull and cervical and sacral spine, if the radiologist captures those anatomical structures in the views. The key difference between the codes is the number of views captured.