72100 Lumbar spine X-ray Medicare reimbursement rates in Oregon

This study images the lumbar vertebrae and lumbosacral junction with two or three plain radiographic views. A common set is an AP and a lateral, sometimes with a coned-down lateral spot of L5-S1 as the third view. Primary care, orthopedic, spine, emergency, and pain management clinicians may order it for back pain, suspected fracture, spondylolisthesis, degenerative change, or hardware position after fusion. A radiologic technologist acquires the images in an office, imaging center, emergency department, or hospital outpatient department; a radiologist or treating physician interprets them.

Code selection depends on the views actually obtained. A standard series with four or more views is reported with 72110; a complete study including bending views requires at least six views for 72114, while bending views alone are reported with 72120. Modifier 26 identifies the professional interpretation and signed report; modifier TC identifies the equipment, supplies, and technologist portion. When the same billing entity provides both portions, it reports the global service without either modifier. For hospital films, the reading physician typically reports modifier 26, while the hospital bills for image acquisition. The report should identify the views and findings.