Coding, Classification & Reimbursement

1.  CPT 72020

Posted 8 days ago
How does one specify the spinal level for the following? I'm not aware of modifiers for spinal level.
CPT 72020 Radiologic examination, spine, single view, specify level


2.  RE: CPT 72020

Posted 8 days ago
​Your diagnosis code should represent the level of spine that has the issue.  In box 19 on the CMS 1500 form you should put 'Cervical x-ray' for example.  There are no specific modifiers to identify the vertebral level.

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Allison Evans, RHIA
Coding Manager
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3.  RE: CPT 72020

Posted 8 days ago
Dear Lorraine,

After reading your post, I went to look up the code in the CPT Manual. Judging from what the instructional note below the code said and the other codes which follow code 72020, I came to the assumption that maybe this code should not be used unless accompanied by another procedure code. If you look at all the other codes in that section, specific portions of the spine are listed and they seem to be able to "stand on their own". With that being said I would choose another code to use for this account. If there are no portions of the spine listed, then I would query the physician for clarification.

Jodi Miller, RHIT, CCS

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Jodi Miller, RHIT, CCS
Outpatient Coder/Abstractor
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4.  RE: CPT 72020

Posted 7 days ago
Jodi, My issue is that 72020 is single view whereas the remaining codes are for multiple views. 





5.  RE: CPT 72020

Posted 7 days ago
I wonder if this related back to filing paper claims using the AMA 1500 Claim Form.   Wasn't there a location on the form to Specify further information, information for those processing the claim ?

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Julianna Perez
Manager, Medical Records
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6.  RE: CPT 72020

Posted 6 days ago
That's possible, but CPT code descriptions don't usually contain
instructions related to the CMS-1500 form. I can't think of any similar
instance off the top of my head. Usually when CPT says to "specify"
information, it can be done with another code or modifier.




7.  RE: CPT 72020

Posted 6 days ago
Dear Lorraine,

I think the multiple views that you are seeing is how that particular scan is ordered. As far as code 72020 I still do not think that it is an appropriate code and that you should query the physician for clarification.

Good Luck

Jodi Miller, RHIT, CCS

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Jodi Miller, RHIT, CCS
Outpatient Coder/Abstractor
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8.  RE: CPT 72020

Posted 6 days ago
​The level is specified in your radiology report by stating cervical, thoracic or lumbar - those are the levels of the spine.  However, rarely do they only do one film.

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Mary Homer
Outpatient Coding Team Lead
St Mary Medical Center
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9.  RE: CPT 72020

Posted 6 days ago
​I forgot to also state this has nothing to do with modifiers or 1500 form- your diagnosis would give a reason for an x-ray to the spine.  Your report would support your code choice - as long as it was one film and stated the area of the spine imaged.  There is no need for modifiers are other "additional information " to enter on a 1500 form.

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Mary Homer
Outpatient Coding Team Lead
St Mary Medical Center
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