QUESTION: I billed a claim for a full-spine X-ray this year and it was denied as an invalid code. Is full-spine X-ray, 72010, no longer a valid code? Is there an alternative code or a new code to describe this X-ray study?
You are indeed correct: 72010, AP and lateral full spine, has been deleted and as you have acutely been made aware, its use will result in a denial. Current Procedural Terminology (CPT), which contains the service and procedure codes use by the health care professions, can and does update annually. While there have been no major updates to X-ray codes specific to chiropractic since the early 2000s, this year features some significant updates that will affect chiropractic billing for X-rays. The good news is that while the code was deleted, there is a new code set to replace it.
Out With the Old, in With the New
Three codes were deleted for 2016, while four new codes were added. Let's start with the three deleted codes, followed by the four new codes:
Deleted
72010 radiologic examination, spine, entire survey study, anteroposterior and lateral
72090 radiologic examination, spine, scoliosis study including supine and erect studies
Added
72081 radiologic examination, spine, entire thoracic and lumbar, including skull, cervical and sacral spine if performed (e.g., scoliosis evaluation); one view
72082 radiologic examination, spine, entire thoracic and lumbar, including skull, cervical and sacral spine if performed (e.g., scoliosis evaluation); 2-3 views
72083 radiologic examination, spine, entire thoracic and lumbar, including skull, cervical and sacral spine if performed (e.g., scoliosis evaluation); 4-5 views
72084 radiologic examination, spine, entire thoracic and lumbar, including skull, cervical and sacral spine if performed (e.g., scoliosis evaluation); six views
Using the New Codes
Per CPT, here is how each of the new codes is to be used as replacement for each of the three deleted codes:
72010 has been deleted; to report, use 72082, as this would reference the two-view or AP and lateral.
72020 has not been deleted and remains valid, but now states a single view of the spine that includes the entire thoracic spine uses 72081.
72069 has been deleted; to report, use 72081, 72082, 72083 or 72084.
72090 has been deleted; use 72081, 72082, 72083 or 72084.
Your CPT lists and fees will need to be updated to accommodate these changes. Note these changes apply to all insurance claims and entities that utilize CPT.
Some doctors thrive in a personality-based clinic and have a loyal following no matter what services or equipment they offer, but for most chiropractic offices who are trying to grow and expand, new equipment purchases help us stay relevant and continue to service our client base in the best, most up-to-date manner possible. So, regarding equipment purchasing: should you lease, get a bank loan, or pay cash?
Some pundits say that the upcoming presidential and congressional races, and many local races, might be the most consequential in our country’s history. We do not have the choice of sitting on the sidelines and hoping our patients will carry our water. Unlike other medical professions such as physical therapists, podiatrists, nurses, etc., the health care class (AMA) will not protect us. We must be in the game.
The most common condition affecting the shoulder is rotator-cuff disease. From acute tears to chronic tendinopathy, it’s common and needs a thorough workup. In fact, even asymptomatic shoulders can have full-thickness rotator-cuff rears in up to 40% of instances. Let’s look at additional conditions that can present to the office with weakness, loss of motion and pain in the shoulder beyond rotator-cuff tears.
