Wiki CPT Code 72010

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nvigliotti

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Warwick, RI
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The radiology practice that I work for is having problem with our local BCBS with regard to denying 72040, 72070 and 72100. BCBSRI wants us to bundle these three CPT codes into 72010 (xray entire spine, survey study, AP and lateral). My issue is that we're performing three views of the cervical spine and have a separate dictation per each anatomic region of the spine. When we appeal (with supporting documention) BCBSRI denies the appeal stating to submit 72010. Before I take this to the next level I was wondering if I'm right in interpretating 72010 as two views of the entire spine with on dictation for the entire spinal survey instead of three separate reports. Thanks for any help you can provide in clarifying this issue!
 
72010

it does not matter how many reports you are submitting, what you need to look at is the definition of 72010 as it includes the ENTIRE spine, so even if you are doing three views, you are still doing the entire spine. with 72010 you are telling the carrier you xrayed the entire spine therefore cannot bill for each level too, that would be double dipping.
 
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