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Chiropractic documentation gap analysis

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Some chiropractors still use 17 X 36 (Gonstead) films, which allow the doctor to view the full spine in a single X-ray. It’s important to know that the code for this kind of X-ray has been changed, affecting the deleted codes 72010, 72069, and 72090. In addition, there was a revision to code 72080. These changes became effective January 1, 2016.

According to CPT®, “these changes simplify the reporting procedures for scoliosis evaluations and other studies; address current changes in clinical practice; and provide a coding structure similar to the structure of other imaging families.” In other words, these changes were made to standardize the hierarchy and language for these code families and align them with other code families.

The code sets being deleted are:

  • 72010 – radiologic examination of the entire spine (replace with 72082)
  • 72069 – radiologic examination, spine, thoracolumbar, standing (scoliosis), (replace with 72081-72084)
  • 72090 – radiologic examination, spine, scoliosis study, including supine and erect studies (replace with 72081-72084)

Replace the above codes with:

  • 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); two or three views
  • 72083 – radiologic examination, spine, entire thoracic and lumbar, including skull, cervical, and sacral spine if performed (e.g., scoliosis evaluation); four to five views
  • 72084 – radiologic examination, spine, entire thoracic and lumbar, including skull, cervical, and sacral spine if performed (e.g., scoliosis evaluation); a minimum of six views

You will need to make the necessary changes to your software and coding systems. Effective January 1, 2016, denials from third-party payers may be seen for deleted codes, if billed.

Posted by nuclearnetworking on Mar 12, 2017

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