How To Use CPT Code 70130

CPT 70130 describes the radiologic examination of the mastoids, involving a complete evaluation with a minimum of three views per side. This article will cover the description, procedure, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information, similar codes and billing examples.

1. What is CPT Code 70130?

CPT 70130 can be used to describe the radiologic examination of the mastoids. This procedure involves taking plain X-rays of the mastoid cavity, with a minimum of three views per side. It is performed to help diagnose conditions such as mastoiditis, vertiginous syndromes, disorders of the vestibular system, or the presence of a swelling, mass, or lump in the head or neck.

2. Official Description

The official description of CPT code 70130 is: ‘Radiologic examination, mastoids; complete, minimum of 3 views per side.’

3. Procedure

1. The healthcare provider takes plain X-rays of the mastoid portion of the temporal bone unilaterally, or on one side.
2. A minimum of three views per side is obtained to ensure a comprehensive evaluation.
3. The provider carefully positions the patient and adjusts the X-ray machine to capture the necessary images.
4. The X-ray images are then developed and interpreted by a radiologist or other qualified healthcare professional.
5. The findings from the examination are documented and used to assist in the diagnosis and treatment of the patient’s condition.

4. Qualifying circumstances

CPT 70130 is typically performed when there is a clinical need to evaluate the mastoid cavity. This may include suspected mastoiditis, vertiginous syndromes, disorders of the vestibular system, or the presence of a swelling, mass, or lump in the head or neck. The procedure is performed unilaterally, meaning it is done on one side of the head. It is important to note that bilateral procedures may require the use of modifier 50 to indicate that the examination was performed on both sides.

5. When to use CPT code 70130

CPT code 70130 should be used when a complete radiologic examination of the mastoids is performed, with a minimum of three views per side. It is important to ensure that the documentation clearly describes each view taken and includes the patient’s body position and the projection of the X-ray. If the procedure is performed bilaterally, check with the payer’s preference for reporting, as it may require reporting the code twice with modifier 50 appended or as a single line item with modifier 50.

6. Documentation requirements

To support a claim for CPT 70130, the healthcare provider must document the following information:

• Reason for the examination, including suspected conditions or symptoms
• Number and description of views obtained per side
• Date and time of the procedure
• Patient’s body position during the examination
• Projection of the X-ray
• Interpretation and findings from the examination
• Signature of the interpreting healthcare professional

7. Billing guidelines

When billing for CPT 70130, ensure that the procedure is performed as described in the official description. If the examination is performed bilaterally, follow the payer’s preference for reporting. It is important to accurately document the number and description of views obtained per side to support the claim. Additionally, be sure to include the appropriate modifiers, such as modifier 50 for bilateral procedures, if required by the payer.

8. Historical information

CPT 70130 was added to the Current Procedural Terminology system on January 1, 1990. The code underwent a change on January 1, 2009, with the updated description specifying a minimum of three views per side for a complete examination of the mastoids.

9. Examples

1. A patient presents with symptoms of vertigo, and the healthcare provider performs a radiologic examination of the mastoids, obtaining a minimum of three views per side to evaluate the vestibular system.
2. A patient has a swelling in the neck, and the healthcare provider orders a radiologic examination of the mastoids to assess for any underlying abnormalities or masses.
3. A patient with suspected mastoiditis undergoes a complete radiologic examination of the mastoids, with a minimum of three views per side, to aid in the diagnosis and treatment planning.
4. A patient with a history of vertiginous syndromes undergoes a routine radiologic examination of the mastoids to monitor the condition and assess for any changes or progression.
5. A patient presents with complaints of ear pain and the healthcare provider performs a radiologic examination of the mastoids to rule out any abnormalities or infections.
6. A patient with a history of head trauma undergoes a radiologic examination of the mastoids to evaluate for any fractures or other injuries to the temporal bone.
7. A patient with chronic ear infections undergoes a complete radiologic examination of the mastoids to assess for any underlying anatomical abnormalities or chronic inflammation.
8. A patient with a suspected vestibular disorder undergoes a radiologic examination of the mastoids to evaluate the vestibular system and assist in the diagnosis and treatment planning.
9. A patient with a history of head and neck cancer undergoes a routine radiologic examination of the mastoids to monitor for any signs of recurrence or metastasis.
10. A patient with a history of vertigo and dizziness undergoes a complete radiologic examination of the mastoids to assess the vestibular system and aid in the management of their symptoms.