Author Topic: 72052 XRay Clinical Guidelines  (Read 1827 times)

Agehman3

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72052 XRay Clinical Guidelines
« on: September 10, 2013, 12:42:36 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.

shanbull

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Re: 72052 XRay Clinical Guidelines
« Reply #1 on: October 21, 2013, 04:14:58 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.
« Last Edit: October 21, 2013, 04:16:35 PM by shanbull »