Billing Spinal X-Rays

Full spine x-rays are not considered to be of diagnostic quality. This is expecially true of 14×36 film. So if a chiropractor decides to x-ray the patient’s entire spine, he should take sectional views and bill the exam using three codes as follows:

72040 Radiologic examination, spine, cervical; 2 or 3 views
72070 Radiologic examination, spine, thoracic; 2 views
72100 Radiologic examination, spine, lumbosacral; 2 or 3 views

The problem is that the insurance company may take these codes and bundle them into a single code and deny the service as not being medically necessary (or at least markedly reduce the coverage). They will do this with one of these four codes:

72081 Radiologic examination, spine, entire thoracic and lumbar, including skull, cervical and sacral spine if performed (eg. scolosis evaluation); one view
72082 2 or 3 views
72083 4 or 5 views
72084 minimum of 6 views

To avoid having your spinal x-rays bundeled only examine two areas of the spine e.g. cervical and lumbar studies.