How To Use CPT Code 72127

CPT 72127 describes the diagnostic procedure of computed tomography (CT) of the cervical spine. This article will cover the description, official details, procedure, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information, similar codes and billing examples.

1. What is CPT Code 72127?

CPT 72127 is used to describe a diagnostic procedure called computed tomography (CT) of the cervical spine. This procedure involves the use of X-ray technology to create cross-sectional images of the neck area without the use of contrast material, followed by additional images after the injection of a contrast material.

2. Official Description

The official description of CPT code 72127 is: ‘Computed tomography, cervical spine; without contrast material, followed by contrast material(s) and further sections.’

3. Procedure

1. During the procedure, the patient is positioned appropriately and may be sedated if necessary.
2. The provider takes cross-sectional images of the cervical spine using a CT scanner without the use of contrast material.
3. After the initial images are obtained, the provider injects a contrast material into the patient.
4. Additional images are then taken to capture the contrast material’s distribution and enhance the visibility of internal structures or organs in the cervical spine.
5. The provider examines the obtained images on a computer monitor and interprets the diagnostic results.

4. Qualifying circumstances

CPT 72127 is used for patients who require a diagnostic CT scan of the cervical spine. This procedure is typically performed to diagnose, manage, and treat diseases or conditions affecting the neck area. The use of contrast material may be necessary to improve the visibility of internal structures or organs. Providers who perform this procedure must ensure that the patient is appropriately positioned and may administer sedation if needed.

5. When to use CPT code 72127

CPT code 72127 should be used when a provider performs a diagnostic CT scan of the cervical spine without contrast material, followed by the injection of a contrast material and additional sections. This code is appropriate when the provider obtains images of the neck area to aid in the diagnosis and management of diseases or conditions affecting the cervical spine.

6. Documentation requirements

To support a claim for CPT 72127, the provider must document the following information:

• Indication for the CT scan of the cervical spine
• Whether contrast material was used and the specific contrast material(s) administered
• Date and time of the procedure
• Details of the images obtained and any abnormalities identified
• Interpretation of the diagnostic results
• Signature of the provider performing the procedure

7. Billing guidelines

When billing for CPT 72127, ensure that the procedure meets the criteria described in the official description. Use the appropriate CPT code based on whether contrast material was used or not. It is important to follow payer guidelines regarding the reporting of contrast material separately, if applicable. Modifier 26 should be appended to the radiology code if only the professional component is being reported, while modifier TC should be appended if only the technical component is being reported. However, payer policies may exempt hospitals from appending modifier TC. It is crucial to review individual payer policies for specific coverage and reporting requirements.

8. Historical information

CPT 72127 was added to the Current Procedural Terminology system on January 1, 1990. The code underwent a change on January 1, 2003, with an updated description.

9. Examples

1. A patient undergoes a diagnostic CT scan of the cervical spine without contrast material to evaluate a suspected cervical disc herniation.
2. A provider performs a CT scan of the cervical spine with contrast material to assess the extent of a cervical spine injury in a trauma patient.
3. A patient with chronic neck pain undergoes a diagnostic CT scan of the cervical spine without contrast material to identify any underlying structural abnormalities.
4. A provider performs a CT scan of the cervical spine with contrast material to evaluate the response to treatment in a patient with a known cervical spine tumor.
5. A patient with suspected cervical spine instability undergoes a diagnostic CT scan without contrast material to assess the integrity of the cervical vertebrae.
6. A provider performs a CT scan of the cervical spine with contrast material to evaluate the presence of infection or inflammation in a patient with persistent neck pain.
7. A patient with a history of cervical spine surgery undergoes a diagnostic CT scan without contrast material to assess the postoperative changes in the cervical spine.
8. A provider performs a CT scan of the cervical spine with contrast material to evaluate the presence of vascular abnormalities in a patient with unexplained neurological symptoms.
9. A patient with a recent traumatic injury to the neck undergoes a diagnostic CT scan without contrast material to assess for fractures or dislocations in the cervical spine.
10. A provider performs a CT scan of the cervical spine with contrast material to evaluate the presence of spinal cord compression in a patient with progressive weakness and sensory changes.