CPT® Code 72090 | Case2Code

Code deleted, see 72081, 72082, 72083, 72084

Official Description

Radiologic examination, spine; scoliosis study, including supine and erect studies

Common Language Description

A radiologic examination of the spine, specifically a scoliosis study, is performed to assess the presence or absence of scoliosis, which is a condition characterized by an abnormal lateral curvature of the spine. This examination aims to identify the location of the curvature, the type of scoliosis, and the degree of curvature present in the patient. The procedure utilizes X-ray technology, which employs indirect ionizing radiation to create images of the internal structures of the body. X-rays are particularly effective in imaging non-uniform materials, such as human tissue, due to the varying densities and compositions of these materials. As a result, some X-rays are absorbed while others pass through, allowing for the creation of a two-dimensional image on a detector positioned behind the patient. During the scoliosis study, multiple views of the spine are typically captured, including posteroanterior (PA), frontal, and lateral perspectives, while the patient is in an erect or upright position. For the PA view, the patient stands in front of a vertical grid with their knees together and legs fully extended. In the lateral view, the patient's arms are positioned straight out in front of them, rather than overhead, to provide a clearer visualization of the spinal curvature. Additionally, images are also obtained while the patient is lying supine (face up), ensuring that the entire spine is included in the field of view. The examination measures the vertebral bodies that are most tilted above and below the apex of the spinal curve, using intersecting lines to determine the degree of curvature accurately.

1. Indications

The scoliosis study, as described by CPT® Code 72090, is indicated for the following conditions:

Suspected Scoliosis - The procedure is performed when there is a clinical suspicion of scoliosis based on physical examination findings.
Monitoring Progression - It is indicated for patients with a known diagnosis of scoliosis to monitor any changes in the curvature over time.
Preoperative Assessment - The study may be necessary for surgical planning in patients who are candidates for spinal surgery due to scoliosis.
Postoperative Evaluation - It is also used to evaluate the effectiveness of surgical interventions in correcting spinal curvature.

2. Procedure

The scoliosis study involves several procedural steps to ensure comprehensive imaging of the spine:

Patient Positioning - The patient is first positioned in an erect or upright stance, standing in front of a vertical grid. It is essential for the patient to keep their knees together and legs fully extended to obtain accurate images.
Posteroanterior (PA) View - An X-ray is taken from the posteroanterior perspective, capturing the spine's alignment and curvature while the patient maintains the specified position.
Lateral View - A lateral projection is then obtained, with the patient’s arms extended straight out in front of them. This positioning helps to enhance the visibility of the spinal curvature.
Supine Positioning - After the erect images are captured, the patient is instructed to lie down in a supine position (face up). This allows for additional imaging of the spine while in a different orientation.
Measurement of Curvature - The radiologist measures the degree of curvature by identifying the vertebral bodies that are most tilted above and below the apex of the spinal curve. This is done using intersecting lines to provide a precise measurement of the curvature.

3. Post-Procedure

After the scoliosis study is completed, the patient may be instructed to resume normal activities unless otherwise advised by the healthcare provider. The images obtained during the procedure will be reviewed by a radiologist, who will interpret the findings and provide a report detailing the presence, location, type, and degree of scoliosis if applicable. This report is essential for guiding further management, whether it involves monitoring, treatment, or surgical intervention. Patients may be scheduled for follow-up appointments to discuss the results and any necessary next steps based on the findings of the study.

Short Descr	X-RAY EXAM SCLOIOSIS ERECT
Medium Descr	RADEX SPINE SCOLIOS STUDY W/SUPINE & ERECT STUDY
Long Descr	Radiologic examination, spine; scoliosis study, including supine and erect studies
Status Code	Active Code
Global Days	XXX - Global Concept Does Not Apply
PC/TC Indicator (26, TC)	1 - Diagnostic Tests for Radiology Services
Multiple Procedures (51)	0 - No payment adjustment rules for multiple procedures apply.
Bilateral Surgery (50)	0 - 150% payment adjustment for bilateral procedures does NOT apply.
Physician Supervisions	09 - Concept does not apply.
Assistant Surgeon (80, 82)	0 - Payment restriction for assistants at surgery applies to this procedure...
Co-Surgeons (62)	0 - Co-surgeons not permitted for this procedure.
Team Surgery (66)	0 - Team surgeons not permitted for this procedure.
Diagnostic Imaging Family	99 - Concept Does Not Apply
APC Status Indicator	STV-Packaged Codes
Type of Service (TOS)	4 - Diagnostic Radiology
Berenson-Eggers TOS (BETOS)	I1B - Standard imaging - musculoskeletal
MUE	Not applicable/unspecified.
CCS Clinical Classification	226 - Other diagnostic radiology and related techniques

GP	Services delivered under an outpatient physical therapy plan of care
GY	Item or service statutorily excluded, does not meet the definition of any medicare benefit or, for non-medicare insurers, is not a contract benefit