Wiki 72020 and 72120

iowagirl77

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I work for an ortho clinic and we're getting a lot of denials this year for 72020 bundling with 72120. When I put it into CodeCorrect, it doesn't bundle. Our providers often do them both for lumbar, but 72120 is for bending views and 72020 is for AP view. The only reason I can think of why some payers now deny are the 2017 NCCI updates regarding billing a full spinal x-ray along with 72020 or 72120, but that isn't the case here. My other thought would be maybe they are supposed to be adding them up and coding as 72100 or 72110? Anyone else have issues with this? Medicare hasn't denied it, but we have denials with UHC, BCBS, Humana and more.

Thanks!
Susan
 
Thanks for the link, but the only thing I see in there is what I have found already:

CPT codes 72081-72084 describe radiologic examination of the entire spine, the codes differing based on the number of views. The other codes in the CPT code range 72020-72120 describe radiologic examination of specific regions of the spine differing based on the region of the spine and the number of views. If a physician performs a procedure described by CPT codes 72081-72084 and at the same patient encounter performs a procedure described by one or more other codes in the CPT code range 72020-72120, the physician should sum the total number of views and report the appropriate code in the CPT code range 72081-72084. The physician should not report a code from the CPT code range 72081-72084 plus another code in the CPT code range 72020-72120 for services performed at the same patient encounter.

Basically, if a full spinal x-ray (72081-72084) is done at the same encounter as another x-ray of any part of the spine (72020-72120) then you would combine the views and report it under range 72081-72084. However, what I'm seeing is not the case. These are for lumbar only, not a full spinal. I do find it interesting that Medicare has no issue with the billing of these codes, and they are usually more strict than commercial payers.
 
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