How To Use CPT Code 72295

CPT 72295 describes the imaging supervision and interpretation for a discogram, a diagnostic procedure used to identify the specific vertebrae causing neck or back pain. 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 72295?

CPT 72295 can be used to represent the imaging supervision and interpretation for a discogram, which is a non-surgical diagnostic procedure used to identify the particular vertebrae causing neck or back pain. The provider performs an injection of contrast material into the disc space of the lumbar spinal canal and takes a series of X-ray images to detect any injury or protrusion of the disc in the spine. This code is used to report only the imaging supervision and interpretation for this procedure.

2. Official Description

The official description of CPT code 72295 is: ‘Discography, lumbar, radiological supervision and interpretation.’

3. Procedure

1. The provider inserts a needle under fluoroscopic guidance and injects contrast material into the disc space of the lumbar spinal canal.
2. The provider changes the position of the patient by tilting the X-ray table to allow the contrast material to reach different levels in the spinal canal.
3. The provider observes the flow using fluoroscopy and takes a series of X-rays of the disc space of the lumbar spinal canal as he changes the patient’s position.

4. Qualifying circumstances

CPT 72295 is used when the provider performs the imaging supervision and interpretation for a discogram. This procedure is typically performed on patients who are experiencing neck or back pain and need to identify the specific vertebrae causing the pain. The provider must use fluoroscopic guidance to insert a needle and inject contrast material into the disc space of the lumbar spinal canal. The purpose of the procedure is to detect any injury or protrusion of the disc in the spine.

5. When to use CPT code 72295

CPT code 72295 should be used when the provider is performing the imaging supervision and interpretation for a discogram. This code should only be reported for the imaging component of the procedure and not for any other services provided. It is important to note that fluoroscopic guidance should not be reported separately with CPT code 77003.

6. Documentation requirements

To support a claim for CPT code 72295, the provider must document the following information:

• Indication for the discogram and the specific vertebrae being evaluated
• Details of the fluoroscopic guidance used during the procedure
• Date and time of the procedure
• Observations made during the procedure, including any abnormalities or findings
• Interpretation of the images and any additional recommendations or follow-up required
• Signature of the provider performing the imaging supervision and interpretation

7. Billing guidelines

When billing for CPT code 72295, ensure that the provider is reporting only the imaging supervision and interpretation for the discogram procedure. This code should not be reported with any other codes for additional services provided during the procedure. It is important to follow Medicare guidelines when multiple providers are involved in the service and to append the appropriate modifiers to indicate reduced service and professional component.

8. Historical information

CPT code 72295 was added to the Current Procedural Terminology system on January 1, 1990. The code was later changed on January 1, 2007 to its current description.

9. Examples

1. A patient presents with severe back pain, and the provider performs the imaging supervision and interpretation for a discogram to identify the specific vertebrae causing the pain.
2. A patient complains of chronic neck pain, and the provider uses CPT code 72295 to report the imaging supervision and interpretation for a discogram to determine the cause of the pain.
3. A provider performs the imaging supervision and interpretation for a discogram on a patient who has been experiencing radiating pain down their leg, aiming to identify the source of the pain.
4. A patient with a history of back injury undergoes a discogram, and the provider reports the imaging supervision and interpretation using CPT code 72295 to assess the condition of the discs in the lumbar spine.
5. A provider performs a discogram on a patient with suspected disc herniation, and CPT code 72295 is used to report the imaging supervision and interpretation of the procedure.
6. A patient with persistent neck pain undergoes a discogram, and the provider uses CPT code 72295 to report the imaging supervision and interpretation to identify the cause of the pain.
7. A provider performs a discogram on a patient with chronic back pain, and CPT code 72295 is used to report the imaging supervision and interpretation of the procedure.
8. A patient presents with symptoms of sciatica, and the provider performs a discogram to determine the specific vertebrae causing the pain, reporting the imaging supervision and interpretation using CPT code 72295.
9. A provider performs a discogram on a patient with suspected degenerative disc disease, and CPT code 72295 is used to report the imaging supervision and interpretation of the procedure.
10. A patient with a history of spinal injury undergoes a discogram, and the provider reports the imaging supervision and interpretation using CPT code 72295 to assess the condition of the discs in the lumbar spine.