2025 CPT code 72100
Effective Date: N/A Revision Date: N/A Radiology Procedures > Diagnostic Radiology (Diagnostic Imaging) Procedures Feed
Radiologic examination, spine, lumbosacral; 2 or 3 views
Modifiers 26 (Professional Component) and TC (Technical Component) can be applied. Modifier 52 (Reduced Services) may also be applicable if fewer than the usual number of views are obtained due to clinical circumstances. Other modifiers like 53, 59, 76, 77, 79, 80, 81, 82, 99, etc., might be applicable depending on the specific situation.
Medical necessity must be established for the exam. This typically involves the documentation of a specific medical condition, injury, or symptom that warrants imaging of the lumbosacral spine.
In simple words: This is a simple X-ray of your lower back. The technician will take 2 or 3 pictures from different angles to help the doctor see the bones and joints clearly.It's used to figure out why your lower back might be hurting or if you have an injury.
This code represents a radiologic examination of the lumbosacral spine, encompassing 2 or 3 views. The procedure involves capturing X-ray images of the lower part of the spine and the sacrum (the area connecting the spine to the pelvis) from different angles.It aids in evaluating back injuries, persistent numbness, and lower back pain. The patient is positioned on an X-ray table, and the technician takes images, usually anteroposterior (AP), lateral, or cone-down views. During the process, the patient holds their breath to prevent blurring. Dense structures like bones appear white on the image due to higher radiation absorption.
Example 1: A patient presents with lower back pain after a fall. A lumbosacral spine X-ray (72100) is ordered to assess for fractures or other injuries., A patient experiences persistent numbness in their legs.Code 72100 is used when 2 or 3 views of the lumbosacral spine are taken to evaluate for nerve compression or disc problems., A patient with a history of degenerative disc disease experiences worsening pain. A lumbosacral spine X-ray is performed to assess the progression of the disease using code 72100 for 2-3 views.
Documentation should specify the number and type of views taken (AP, lateral, cone-down), the reason for the examination, and the patient's symptoms. Any relevant history, such as prior injuries or diagnoses, should also be noted.
** For a complete examination (minimum of six views), use code 72114. For four views, use 72110. For bending views only (2-3 views), use code 72120. Payer policies may vary regarding modifier usage, especially for the TC modifier in hospital settings.
- Modifier TC rule: Yes. Modifier TC can be used when billing for only the technical component of the procedure.
- Specialties:Radiology, Orthopedics, Neurosurgery, Pain Management, Primary Care
- Place of Service:"Office","Inpatient Hospital","On Campus-Outpatient Hospital","Off Campus-Outpatient Hospital","Independent Clinic","Emergency Room - Hospital"