Radiologic examination, spine, thoracic; minimum 4 views

CPT 72074 is the billing code for "Radiologic examination, spine, thoracic; minimum 4 views". For thoracic spine X-ray with minimum 4 views

Medicare pays approximately $43.34 for CPT 72074 (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 72074 has a total RVU of 3.68, broken down as: Work RVU 0.80, Practice Expense RVU 2.80, and Malpractice RVU 0.08. RVUs (Relative Value Units) determine Medicare reimbursement rates.

Key documentation requirements for CPT 72074 include: Indication for thoracic spine X-ray; Minimum 4 views obtained; Findings and interpretation; Alignment assessment. Missing or incomplete documentation is a leading cause of claim denials for this code.

Bundling considerations for CPT 72074: Includes minimum 4 views thoracic spine. Includes interpretation and report Use an NCCI bundling checker to verify specific code combinations before billing.

Common modifiers for CPT 72074 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 72074 is 15-20 minutes typical procedure time. Time-based codes require documentation of the actual time spent providing the service.