Medical Billing Forum

Coding => Coding => : Agehman3 September 10, 2013, 03:42:36 PM

: 72052 XRay Clinical Guidelines
: Agehman3 September 10, 2013, 03:42:36 PM
hi...I work for an upper cervical chiro - we often take cpt 72052 x-rays does anyone know the coding/clinical guidelines for this? Sometimes they are approved; sometimes not.
: Re: 72052 XRay Clinical Guidelines
: shanbull October 21, 2013, 07:14:58 PM
We get our clinical guidelines from the insurer in most cases. The plans that require precertification for x-rays even give us a list of applicable criteria as well as which x-ray CPT codes they will pay for when billed by a chiropractor. It's possible that some insurers will pay for 72050 but not 75052 simply because they've decided that over 5 views is excessive for diagnosis. We keep a list of what is required and covered by each insurer handy.