How To Use CPT Code 72126

CPT 72126 describes the diagnostic procedure of computed tomography (CT) examination of the cervical spine with contrast material. 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 72126?

CPT 72126 is used to describe a diagnostic procedure called computed tomography (CT) examination of the cervical spine with contrast material. This procedure involves rotating an X-ray tube and X-ray detectors around the patient to produce cross-sectional images of the neck area. The provider uses CT to diagnose, manage, and treat diseases affecting the cervical spine.

2. Official Description

The official description of CPT code 72126 is: ‘Computed tomography, cervical spine; with contrast material.’

3. Procedure

1. The patient is positioned appropriately and may be sedated if necessary.
2. The provider instructs the patient to remain motionless during the procedure.
3. The provider rotates an X-ray tube and X-ray detectors around the patient, taking cross-sectional images of the cervical spine.
4. The provider administers contrast material to improve the visibility of internal structures or organs.
5. The provider examines the obtained images on a computer monitor and interprets the diagnostic results.

4. Qualifying circumstances

CPT 72126 is used when a provider performs a CT examination of the cervical spine with contrast material. The contrast material can be administered intravascularly, intraarticularly, or intrathecally. It is important to note that when the provider administers oral or rectal contrast, the service should be coded as without contrast because the radiology service already includes these types of contrast.

5. When to use CPT code 72126

CPT code 72126 should be used when a provider performs a CT examination of the cervical spine with contrast material. It is important to ensure that the contrast material is administered in a manner that qualifies for this code, such as intravascular, intraarticular, or intrathecal administration. If the examination is performed without contrast material, CPT code 72125 should be used instead.

6. Documentation requirements

To support a claim for CPT code 72126, the provider must document the following information:

• Indication for the CT examination of the cervical spine with contrast material
• Details of the contrast material administered, including route and amount
• Date and time of the procedure
• Interpretation of the diagnostic results
• Signature of the provider performing the procedure

7. Billing guidelines

When billing for CPT code 72126, ensure that the procedure involves a CT examination of the cervical spine with contrast material. It is important to follow payer guidelines regarding the reporting of contrast material separately, using appropriate supply codes or HCPCS Level II codes. Modifier 26 should be appended to the radiology code if reporting only the physician’s interpretation, and modifier TC should be appended if reporting only the technical component. However, payer policies may exempt hospitals from appending modifier TC. It is crucial to review individual payer policies for specific guidelines and reporting requirements.

8. Historical information

CPT code 72126 was added to the Current Procedural Terminology system on January 1, 1990, with a code change on January 1, 2003. There have been no further updates to the code since its addition.

9. Examples

1. A patient undergoes a CT examination of the cervical spine with contrast material to evaluate a suspected spinal injury.
2. A provider performs a CT examination of the cervical spine with contrast material to assess the extent of a tumor in the neck area.
3. A patient with chronic neck pain undergoes a CT examination of the cervical spine with contrast material to identify any underlying causes.
4. A provider orders a CT examination of the cervical spine with contrast material for a patient with suspected spinal stenosis.
5. A CT examination of the cervical spine with contrast material is performed on a patient with a history of cervical disc herniation to assess the condition of the discs.
6. A provider uses CT with contrast material to evaluate the effectiveness of a previous cervical spine surgery in a patient.
7. A patient with a suspected infection in the cervical spine undergoes a CT examination with contrast material to identify any signs of inflammation.
8. A provider performs a CT examination of the cervical spine with contrast material to assess the alignment of the vertebrae in a patient with scoliosis.
9. A CT examination with contrast material is performed on a patient with suspected spinal cord compression in the cervical spine.
10. A provider orders a CT examination of the cervical spine with contrast material to evaluate the presence of any abnormalities in a patient with unexplained neurological symptoms.