How To Use CPT Code 72190

CPT code 72190 describes a radiologic examination of the pelvis, which involves taking a minimum of three X-ray images to assess for fractures, swelling, or sources of pain in the pelvic area. 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 72190?

CPT 72190 can be used to describe a radiologic examination of the pelvis, where a minimum of three X-ray images are taken to evaluate the pelvic bone for any abnormalities. This code is used when the provider wants to assess for fractures, swelling, or sources of pain in the pelvic area.

2. Official Description

The official description of CPT code 72190 is: ‘Radiologic examination, pelvis; complete, minimum of three views.’ This code is used when a provider takes a minimum of three X-ray images of the pelvic bone to evaluate for any fractures, swelling, or sources of pain.

3. Procedure

1. The provider assesses the patient’s symptoms and determines the need for a radiologic examination of the pelvis.
2. A minimum of three X-ray images are taken of the pelvic bone from different angles to obtain a complete study.
3. The X-ray machine emits a beam of radiation through the pelvis, and the images are recorded on special film.
4. The X-ray images show the bones of the pelvis, including the hip bones, sacrum, and coccyx (tailbone).
5. In some cases, additional images may be taken with the patient lying on their side to obtain a side view of the pelvis and a view of a single hip.

4. Qualifying circumstances

CPT 72190 is used for patients who require a radiologic examination of the pelvis to evaluate for fractures, swelling, or sources of pain. This code is applicable when a minimum of three X-ray images are taken to obtain a complete study of the pelvic bone. The provider must document the medical necessity for the examination and the specific findings observed during the procedure.

5. When to use CPT code 72190

CPT code 72190 should be used when a provider wants to perform a radiologic examination of the pelvis using a minimum of three X-ray images. This code is appropriate when there is a clinical indication to evaluate for fractures, swelling, or sources of pain in the pelvic area. It should not be used for other types of imaging studies or when fewer than three X-ray images are taken.

6. Documentation requirements

To support a claim for CPT 72190, the provider must document the following information:

• Clinical indication for the radiologic examination of the pelvis
• Number and type of X-ray images taken (minimum of three)
• Specific findings observed during the examination
• Date and time of the procedure
• Signature of the provider performing the examination

7. Billing guidelines

When billing for CPT 72190, ensure that the provider performs a radiologic examination of the pelvis using a minimum of three X-ray images. It is important to append the appropriate modifiers if reporting only the professional or technical component of the service. Additionally, be aware of payer policies regarding the use of modifiers and the reporting of global services. It is also important to note that CPT 72190 should not be reported with other codes that represent a combined computed tomography (CT) or computed tomographic angiography (CTA) study of the abdomen and pelvis.

8. Historical information

CPT 72190 was added to the Current Procedural Terminology system on January 1, 1990. The code underwent a change on January 1, 2009, where the description was revised to specify a minimum of three views for a complete study of the pelvis.

9. Examples

1. A patient presents with pelvic pain, and the provider performs a radiologic examination of the pelvis using a minimum of three X-ray images to assess for any fractures or sources of pain.
2. A trauma patient is brought to the emergency department with suspected pelvic fractures, and the provider orders a radiologic examination of the pelvis with a minimum of three X-ray images to confirm the diagnosis.
3. A patient with a history of osteoporosis undergoes a routine radiologic examination of the pelvis using a minimum of three X-ray images to monitor bone density and assess for any fractures.
4. A pregnant patient experiences pelvic discomfort, and the provider performs a radiologic examination of the pelvis using a minimum of three X-ray images to rule out any pelvic abnormalities.
5. A patient with a history of hip pain undergoes a radiologic examination of the pelvis using a minimum of three X-ray images to evaluate for any hip joint abnormalities or fractures.
6. A patient involved in a motor vehicle accident complains of pelvic pain, and the provider orders a radiologic examination of the pelvis with a minimum of three X-ray images to assess for any fractures or injuries.
7. A patient with a suspected pelvic tumor undergoes a radiologic examination of the pelvis using a minimum of three X-ray images to evaluate the extent and location of the tumor.
8. A postmenopausal woman with pelvic pain undergoes a radiologic examination of the pelvis using a minimum of three X-ray images to assess for any pelvic organ abnormalities or fractures.