Radiologic examination, spine, single view, code list

CPT 72020 is the billing code for "Radiologic examination, spine, single view, code list". For single view spine X-ray

Medicare pays approximately $23.61 for CPT 72020 (national average). Actual payment varies by geographic location due to GPCI adjustments. Hospital and commercial insurance rates are typically 2-4x higher than Medicare rates.

CPT 72020 has a total RVU of 1.53, broken down as: Work RVU 0.30, Practice Expense RVU 1.20, and Malpractice RVU 0.03. RVUs (Relative Value Units) determine Medicare reimbursement rates.

Key documentation requirements for CPT 72020 include: Indication for spine X-ray; Single view obtained; Spine region; Findings and interpretation. Missing or incomplete documentation is a leading cause of claim denials for this code.

Bundling considerations for CPT 72020: Includes single view. Includes interpretation and report Use an NCCI bundling checker to verify specific code combinations before billing.

Common modifiers for CPT 72020 include: 26 (Professional component only (interpretation)), TC (Technical component only (equipment/staff)), 59 (Distinct procedural service if performed separately). Modifiers indicate special circumstances and can affect reimbursement or prevent claim denials.

The typical time requirement for CPT 72020 is 5-10 minutes typical procedure time. Time-based codes require documentation of the actual time spent providing the service.