How To Use CPT Code 72200

CPT 72200 describes the radiologic examination of the sacroiliac joints using less than three views. 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 72200?

CPT 72200 can be used to describe the radiologic examination of the sacroiliac joints using less than three views. This code is used when a healthcare provider takes one or two X-ray views of the sacroiliac joints to check for any fractures, swelling, or reasons for pain in the lower back area.

2. Official Description

The official description of CPT code 72200 is: ‘Radiologic examination, sacroiliac joints; less than three views.’

3. Procedure

1. The healthcare provider positions the patient and selects the appropriate views for the radiologic examination of the sacroiliac joints.
2. The X-ray machine sends a beam of radiation through the sacroiliac joints, and the provider records the images on special film or computer.
3. The images taken are usually from the anteroposterior (front to back) or oblique views from the right and left side.
4. The X-ray images show the condition of the sacroiliac joints, including any fractures, swelling, or other abnormalities.

4. Qualifying circumstances

Patients eligible to receive CPT 72200 services are those who require a radiologic examination of the sacroiliac joints using less than three views. This procedure is typically performed to evaluate lower back pain or suspected sacroiliac joint dysfunction. The healthcare provider must document the medical necessity for the examination and ensure that the patient meets the criteria for the procedure.

5. When to use CPT code 72200

CPT code 72200 should be used when a healthcare provider performs a radiologic examination of the sacroiliac joints using less than three views. This code is appropriate when the provider takes one or two X-ray views to assess the condition of the sacroiliac joints. If three or more views are taken, CPT code 72202 should be used instead.

6. Documentation requirements

To support a claim for CPT 72200, the healthcare provider must document the following information:

• Reason for the radiologic examination of the sacroiliac joints
• Number and type of views taken
• Date of the examination
• Any findings or abnormalities observed
• Signature of the healthcare provider performing the examination

7. Billing guidelines

When billing for CPT 72200, ensure that the healthcare provider performs a radiologic examination of the sacroiliac joints using less than three views. If only the physician’s interpretation is being reported, append modifier 26 to the radiology code. If only the technical component is being reported, append modifier TC to the radiology code. However, check payer policies as hospitals may be exempt from appending modifier TC. Do not append a professional or technical modifier when reporting a global service where one provider renders both components. It is important to accurately describe each view taken in the radiology service and check the documentation for the patient’s body position and projection of the X-ray to assign the correct number of views.

8. Historical information

CPT 72200 was added to the Current Procedural Terminology system on January 1, 1990. The code underwent a change on January 1, 2009, with the description being updated to ‘Radiologic examination, sacroiliac joints; less than three views.’

9. Examples

1. A patient presents with lower back pain, and the healthcare provider performs a radiologic examination of the sacroiliac joints using two views to assess for any fractures or abnormalities.
2. Following a fall, a patient experiences pain in the sacroiliac joint area, and the healthcare provider orders a radiologic examination using one view to evaluate for any injuries.
3. A patient with suspected sacroiliac joint dysfunction undergoes a radiologic examination using two views to assess the condition of the joints and determine the appropriate treatment plan.
4. During a routine check-up, a healthcare provider performs a radiologic examination of the sacroiliac joints using two views to screen for any potential issues or abnormalities.
5. A patient with chronic lower back pain undergoes a radiologic examination using one view to assess the sacroiliac joints and identify any potential causes of the pain.
6. Following a sports injury, a patient presents with localized pain in the sacroiliac joint area, and the healthcare provider performs a radiologic examination using two views to evaluate for any fractures or injuries.
7. A pregnant patient complains of discomfort in the sacroiliac joint area, and the healthcare provider orders a radiologic examination using one view to assess the joints and ensure there are no complications.
8. A patient with a history of sacroiliac joint dysfunction undergoes a radiologic examination using two views to monitor the progression of the condition and determine the effectiveness of the treatment.
9. During a pre-employment medical evaluation, a healthcare provider performs a radiologic examination of the sacroiliac joints using one view to ensure the patient is fit for the job and does not have any underlying issues.
10. A patient involved in a car accident complains of lower back pain, and the healthcare provider orders a radiologic examination using two views to assess for any fractures or injuries in the sacroiliac joints.