tci ED Coding & Reimbursement Alert - 2022 Issue Q1

Reader Questions: Look to Multiple X-Ray Codes for This Scenario

Question: Encounter notes indicate that the provider performed X-rays on two areas of a patient’s spine: C4-C7 and T1-T3. How many CPT® codes do I need for this encounter, and do I need a modifier? Louisiana Subscriber Answer: You’ll need a pair of CPT® codes to correctly represent this encounter, but you likely won’t need a modifier (more on that later). On the claim, report 72040 (Radiologic examination, spine, cervical; 2 or 3 views) for the cervical X-ray. This accounts for the cervical spinal areas your provider X-rayed (C4-C5, C5-C6, C6-C7). Then report 72070 (Radiologic examination...

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