How To Use CPT Code 72130

CPT 72130 describes the diagnostic procedure of computed tomography (CT) of the thoracic spine. 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 72130?

CPT 72130 is used to describe the diagnostic procedure of CT of the thoracic spine. This code is used when a healthcare provider performs a CT examination of the thoracic spine without using contrast material, followed by contrast material and further sections. CT is a method of rotating an X-ray tube and X-ray detectors around a patient to produce cross-sectional images, which helps in diagnosing, managing, and treating diseases.

2. Official Description

The official description of CPT code 72130 is: ‘Computed tomography, thoracic spine; without contrast material, followed by contrast material(s) and further sections.’

3. Procedure

1. The patient is appropriately positioned and sedated for the procedure.
2. The healthcare provider instructs the patient to remain motionless during the CT scan.
3. The patient lies on the scanner bed, which moves slowly into the scanner.
4. The provider takes cross-sectional images of the thoracic spine without injecting contrast material.
5. The provider then injects contrast material through the vein and obtains a second set of images.
6. The provider interprets the diagnostic results from the thoracic images obtained.
7. The images are stored, reconstructed, and reproduced for further evaluation if necessary.

4. Qualifying circumstances

CPT 72130 is used when a healthcare provider performs a CT scan of the thoracic spine without contrast material, followed by contrast material and further sections. The contrast material can be administered intravascularly, intraarticularly, or intrathecally. It is important to note that oral or rectal contrast does not qualify for this code. The procedure is typically performed to diagnose, manage, and treat diseases of the thoracic spine.

5. When to use CPT code 72130

CPT code 72130 should be used when a healthcare provider performs a CT scan of the thoracic spine without contrast material, followed by contrast material and further sections. It is important to ensure that the contrast material is administered intravascularly, intraarticularly, or intrathecally for this code to be applicable. If the provider administers oral or rectal contrast, a different code should be used. This code is used for diagnostic purposes and helps in evaluating diseases of the thoracic spine.

6. Documentation requirements

To support a claim for CPT 72130, the healthcare provider must document the following information:

• Indication for the CT scan of the thoracic spine
• Whether contrast material was used and the route of administration
• Date and time of the procedure
• Specific findings and interpretations from the images obtained
• Signature of the healthcare provider performing the procedure

7. Billing guidelines

When billing for CPT 72130, it is important to ensure that the procedure is performed as described in the official description. The use of contrast material and the specific route of administration should be documented accurately. It is also 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 physician’s interpretation is being reported, and 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 important to review individual payer policies for specific billing guidelines.

8. Historical information

CPT 72130 was added to the Current Procedural Terminology system on January 1, 1990. There have been historical changes to the code, including a code change on January 1, 2003, which updated the description to include the use of contrast material.

9. Examples

1. A healthcare provider performs a CT scan of the thoracic spine without contrast material, followed by contrast material and further sections to evaluate a patient with suspected spinal cord compression.
2. A patient with a history of trauma undergoes a CT scan of the thoracic spine without contrast material, followed by contrast material and further sections to assess for any fractures or dislocations.
3. A healthcare provider performs a CT scan of the thoracic spine without contrast material, followed by contrast material and further sections to evaluate a patient with suspected spinal tumors.
4. A patient with persistent back pain undergoes a CT scan of the thoracic spine without contrast material, followed by contrast material and further sections to assess for any degenerative changes or herniated discs.
5. A healthcare provider performs a CT scan of the thoracic spine without contrast material, followed by contrast material and further sections to evaluate a patient with suspected spinal infections.
6. A patient with a history of radiation therapy undergoes a CT scan of the thoracic spine without contrast material, followed by contrast material and further sections to assess for any radiation-induced changes or complications.
7. A healthcare provider performs a CT scan of the thoracic spine without contrast material, followed by contrast material and further sections to evaluate a patient with suspected spinal stenosis.
8. A patient with neurological symptoms undergoes a CT scan of the thoracic spine without contrast material, followed by contrast material and further sections to assess for any spinal cord abnormalities or lesions.
9. A healthcare provider performs a CT scan of the thoracic spine without contrast material, followed by contrast material and further sections to evaluate a patient with suspected spinal fractures.