You Be the Coder:
Three-view X-ray
Published on Fri Sep 01, 2000
Test your coding knowledge. Determine how you would code this situation before looking at the box below for the answer.
Question: I have been using CPT 72040 and 72020 to report a three-view x-ray. Some insurance companies are refusing to pay for
CPT 72020 . Can you advise me?
Pennsylvania Subscriber
Answer: You should bill >code 72040 (radiologic examination, spine, cervical; anteroposterior and lateral) and not code 72020 (radiologic examination, spine, single view, specify level) for this service. Generally, it is accepted that CPT Code descriptions that specify a minimum number of views should be billed even when more than the minimum number is obtained to complete the radiographic study.
Most insurance carriers will not pay for a single view x-ray when billed at the same session as a multiple view x-ray. The edits in place by many payers will kick out the additional view as an inclusive service and consider it a bundled procedure.
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