Coding and Billing Updates for Spinal X-Rays

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
• 72069 radiologic examination, spine, thoracolumbar standing (scoliosis)
• 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.