Wiki Spine codes 72081 - 72084


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I am still confused about the spine codes 72081-72084. I was wondering how to count the number of views. For example, today we did a 5 view C spine, 2v T spine (AP/Lat) 4v L spine (AP/Lat/Obliques) and 3v sacrum/coccyx. Would you code this as 72083 - 1 AP of the entire spine and 1 LAT of the entire spine PLUS Obliques of L spine for a total of 4 views? I didn't count the C spine and the sacrum views since the CPT code description says "if performed" and I don't think you are supposed to count the T and L spine views separately. How is the radiologist supposed to dictate this? 4 separate reports or one report? This was not a scoliosis study. Thank you

Given your description, you would bill 72084 for everything performed.

72084 is for a "Radiologic examination of the spine, entire thoracic and lumbar, including skull, cervical and sacral spine if performed, minimum 6 views." The Procedure Desk Reference further describes this code as: "The provider. . . takes images of the thoracic and lumbar spine from at least six directions; the images may include the skull, cervical spine (neck), and sacrum (tailbone)." Note that the description does not state "6 different directions" only "6 directions". That means that an A/P view of the thoracic spine and A/P view of the lumbar spine represents 2 views, not 1.

From your example, you describe 6 views of the thoracic and lumbar spine [2v T spine (AP/Lat) + 4v L spine (AP/Lat/Obliques)], and your cervical spine study [5 view C spine] and sacrum study [3v sacrum/coccyx] are also included in this code per the CPT code description. The requirement for this code is a "minimum of 6 views," which really translates to "6 views or more." Your radiologist can dictate this as one report with separate headers for each study (thoracic, lumbar, cervical, and sacrum) or four separate studies. All that matters is that it is documented.

Hope that helps.