This is a medical billing code employed for radiologic examinations of the lumbosacral spine, specifically when 2 or 3 views are taken. This code is predominantly used by medical professionals to accurately document and bill for this specific type of diagnostic imaging service.
The official description for the CPT code 72100 is: “Radiologic examination, spine, lumbosacral; 2 or 3 views.”
Short description: Lumbosacral spine x-ray, 2 or 3 views.
Procedure for CPT Code 72100
The patient lies on the X-ray table in different positions depending on the views required by the technician. The X-ray machine is normally positioned over the lower part of the patient’s spine.
The patient is asked to hold their breath as the imaging is taking place to prevent blurring. The image is then recorded on a computer or special film. Two or three images are usually taken during this procedure including , the AP [anteroposterior], lateral, and/or cone-down views.
Qualifying circumstances CPT Code 72100
Patients experiencing back injuries, persistent numbness , and low back pain are may qualify to receive services under CPT code 72100. Patients with suspected spinal abnormalities or conditions needing diagnostic evaluation can also qualify for this diagnostic imaging service.
When to use CPT Code 72100
Code 72100 is to be used when a provider performs a radiologic examination of the lumbosacral spine with 2 or 3 views. This code should be used when the examination is medically necessary for the diagnosis or treatment of the patient’s condition.
The following information should be documented to support a claim for CPT 72100, it should include: A detailed description of each view taken during the examination, The patient’s body position and projection of the X-ray for each view, Any clinical findings or observations made during the examination, A clear indication of the medical necessity for the examination is also required.
Billing guidelines CPT Code 72100
When billing for CPT code 72100, keep the following guidelines in mind: Use code 72110 for a minimum of four views of the lumbosacral spine. Use code 72114 for a complete, or minimum of six views, of the lumbosacral spine.
Use code 72120 for two or three views, bending views only, of the lumbosacral spine. Append professional component modifier 26 to the radiology code when reporting only the physician’s interpretation.
Append modifier TC to the radiology code when reporting only the technical component for the radiology service. Avoid appending a professional or technical modifier when reporting a global service in which one provider renders both components.
Historical Information and Similar codes to CPT Code 72100
CPT code 72100 was added to the Current Procedural Terminology system on January 1, 1990. The code has undergone changes in its descriptor over the years, with the most recent change taking place on January 1, 2009. Similar codes to CPT 72100 include CPT 72110, 72114, 72120, 72080 and 72090.
Examples of CPT Code 72100
Some examples of situations whereby procedure done using CPT Code 72100 might be employed include:
- a patient with a history of low back pain undergoing a lumbosacral spine X-ray with AP and lateral views,
- a patient with a suspected herniated disc receiving a lumbosacral spine X-ray with AP and lateral views,
- a patient with a history of spinal stenosis undergoing a lumbosacral spine X-ray with AP and cone-down views,
- a patient with suspected spondylolisthesis receiving a lumbosacral spine X-ray with lateral and cone-down views,
- a patient with a history of scoliosis undergoing a lumbosacral spine X-ray with AP and lateral views, and
- a patient with chronic back pain brought about by a suspected fracture in the lumbosacral region undergoing a lumbosacral spine X-ray.