How To Use CPT Code 72052

CPT 72052 is a diagnostic radiologic examination of the cervical spine with six or more views. This article will cover the description, procedure, qualifying circumstances, when to use the code, documentation requirements, billing guidelines, historical information, similar codes, and examples of CPT 72052 procedures.

1. What is CPT 72052?

CPT 72052 is a diagnostic radiologic examination code used for the cervical spine when six or more views are taken. This procedure is performed to examine the patient’s spine for conditions such as abnormal curves, fractures, or cancer. The code is used by medical coders and billers to report the service provided by the healthcare provider.

2. 72052 CPT code description

The official description of CPT code 72052 is: “Radiologic examination, spine, cervical; 6 or more views.”

3. Procedure

The 72052 procedure involves the following steps:

1. The patient is positioned on the examination table, and the X-ray machine is adjusted to the appropriate height and angle.
2. The provider takes an initial X-ray image of the cervical spine from a standard anterior-posterior (AP) view.
3. Additional views are taken, including lateral, oblique, and flexion-extension views, to obtain a total of six or more images.
4. The X-ray images are reviewed by the provider to assess the cervical spine for any abnormalities or issues.
5. If necessary, the provider may recommend further diagnostic tests or treatment based on the findings of the radiologic examination.

4. Qualifying circumstances

Patients who are eligible to receive CPT code 72052 services include those with:

• Neck pain or stiffness
• History of cervical spine trauma or injury
• Signs or symptoms of cervical spine instability
• Abnormal findings on a previous cervical spine X-ray or other imaging study
• Known or suspected cervical spine disorders, such as degenerative disc disease, spinal stenosis, or spondylolisthesis

5. When to use CPT code 72052

It is appropriate to bill the 72052 CPT code when the provider performs a diagnostic radiologic examination of the cervical spine with six or more views. This code should be used when the examination is necessary to diagnose, manage, or treat a patient’s cervical spine condition or symptoms.

6. Documentation requirements

To support a claim for CPT 72052, the provider’s documentation should include:

• A detailed description of the patient’s presenting symptoms or condition
• The medical necessity for the radiologic examination
• A clear description of each view taken during the examination, including the patient’s body position and projection of the X-ray
• The provider’s interpretation of the X-ray images and any findings or diagnoses
• Any recommendations for further diagnostic tests or treatment based on the examination results

7. Billing guidelines

When billing for CPT code 72052, keep in mind the following guidelines:

• Append professional component modifier 26 to the radiology code when reporting only the physician’s interpretation of the radiology service.
• Append modifier TC to the radiology code when reporting only the technical component of the radiology service. Note that payer policy may exempt hospitals from appending modifier TC because the hospital’s portion is inherently technical.
• Do not append a professional or technical modifier to the radiology code when reporting a global service in which one provider renders both the professional and technical components.
• Ensure that the provider’s documentation clearly describes each view taken in the radiology service and includes the patient’s body position and projection of the X-ray to assign the correct number of views.

8. Historical information

CPT 72052 was added to the Current Procedural Terminology system on January 1, 1990. The code was changed on January 1, 2013, with the previous descriptor being “Radiologic examination, spine, cervical; complete, including oblique and flexion and/or extension studies.”

9. Similar codes to CPT 72052

Five similar codes to CPT 72052 and how they differentiate are:

1. CPT 72040: This code is used for a radiologic examination of the cervical spine with two or three views.
2. CPT 72050: This code is used for a radiologic examination of the cervical spine with four or five views.
3. CPT 72069: This code is used for a radiologic examination of the entire spine for scoliosis with a minimum of two views.
4. CPT 72070: This code is used for a radiologic examination of the thoracic spine with a minimum of two views.
5. CPT 72074: This code is used for a radiologic examination of the lumbosacral spine with a minimum of six views.

10. Examples

Here are 10 detailed examples of CPT code 72052 procedures:

1. A patient with a history of cervical spine trauma presents with neck pain and stiffness. The provider performs a radiologic examination of the cervical spine with six views, including AP, lateral, oblique, and flexion-extension views.
2. A patient with known degenerative disc disease in the cervical spine presents with worsening neck pain. The provider performs a radiologic examination of the cervical spine with six views to assess the progression of the disease.
3. A patient with a suspected cervical spine fracture after a fall undergoes a radiologic examination of the cervical spine with six views to confirm the diagnosis and determine the extent of the injury.
4. A patient with signs of cervical spine instability, such as difficulty walking or maintaining balance, undergoes a radiologic examination of the cervical spine with six views to evaluate the cause of the instability.
5. A patient with a previous abnormal cervical spine X-ray undergoes a radiologic examination of the cervical spine with six views for further evaluation and diagnosis.
6. A patient with neck pain and a history of cancer undergoes a radiologic examination of the cervical spine with six views to assess for possible metastasis to the cervical spine.
7. A patient with a known cervical spine disorder, such as spinal stenosis, undergoes a radiologic examination of the cervical spine with six views to monitor the condition and guide treatment decisions.
8. A patient with neck pain and a history of rheumatoid arthritis undergoes a radiologic examination of the cervical spine with six views to evaluate for possible joint damage or inflammation.
9. A patient with a suspected cervical spine infection undergoes a radiologic examination of the cervical spine with six views to identify the location and extent of the infection.
10. A patient with a history of cervical spine surgery presents with new neck pain and stiffness. The provider performs a radiologic examination of the cervical spine with six views to assess for possible complications or issues related to the surgery.