01/25/2016

Important Information Regarding CPT Code 72010

Codes occasionally change, whether they are CPT, ICD-10, or HCPCS codes. 72010 is a CPT code, which is controlled and copywritten by the American Medical Association (AMA). It is the AMA’s job to make sure that as technology and health care changes, the CPT codes continue to best describe the services that are being performed by health care providers of all types. 

This year, two CPT radiology codes that are commonly used by chiropractors were eliminated and replaced by four new codes. The eliminated codes are 72010, radiological examination, spine, entire, survey study, anteroposterior (AP) and lateral, and 72069, radiological examination, spine, thoracolumbar, standing. 

The new codes are:

• 72081, radiological examination, spine, entire thoracic and lumbar, including skull, cervical and sacral spine, 1 view.
• 72082, radiological examination, spine, entire thoracic and lumbar, including skull, cervical and sacral spine, 2-3 views.
• 72083, radiological examination, spine, entire thoracic and lumbar, including skull, cervical and sacral spine, 4-5 views.
• 72084, radiological examination, spine, entire thoracic and lumbar, including skull, cervical and sacral spine, minimum of 6 views. 

These four new codes are designed to describe an x-ray view on a large enough film that captures an image from the skull through the sacral spine. For DCs, this is usually done for a scoliosis screening. If a DC is taking x-rays of the full spine, or most of it, they usually are doing it as a series of x-rays. For example, if the doctor wants to see AP and lateral views of the cervical, thoracic, and lumbar regions of the spine, they will often actually take six views, two views of each region. 

If that is the case, rather than billing 72082 (or even 72084), billing 72040, radiologic examination, spine, cervical; 2 or 3 views, 72070, radiologic examination, spine, thoracic, 2 views, and 72100, radiologic examination, spine, lumbosacral; 2 or 3 views, better describes the service. Your responsibility is to bill the codes that best describe the service that was actually performed. 

It has become common practice to bill 72010 rather than the three codes that better describe what is being done, because of the practice of insurers “bundling” multiple x-ray codes into a single code. We believe that this practice of insurers, if still practiced, is very questionable under our current laws. Medicaid is an exception to this, and we would anticipate that they will continue to bundle.

If you have any further questions regarding this, please contact the MAC at 517.367.2225 or info@chiromi.com.