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A radiologic examination of the pelvis, designated by CPT® Code 72190, involves a comprehensive diagnostic X-ray procedure that captures a minimum of three distinct views of the pelvic region. This examination utilizes indirect ionizing radiation to create images of the internal structures of the body. The principle behind X-ray imaging is based on the varying densities and compositions of different materials, such as human tissues. When X-rays are directed towards the body, some rays are absorbed by denser materials like bones, while others pass through softer tissues, resulting in a two-dimensional image that highlights these differences. In the resulting images, bones typically appear white due to their density, whereas soft tissues and fluids are represented in various shades of gray. Pelvic X-rays are particularly indicated when patients present with symptoms such as pain or injury in the pelvic area or hip joints. This examination is crucial for assessing potential fractures, detecting arthritis, or identifying other bone diseases. During the procedure, the patient is positioned on an examination table, and various views of the pelvis are obtained by adjusting the position of the legs and feet. For instance, the patient may be instructed to turn their feet inward to point towards each other or to bend their knees outward with the soles of their feet together in a 'frog-leg' position. It is important to note that for a complete pelvic X-ray examination consisting of three or more views, CPT® Code 72190 should be reported, whereas CPT® Code 72170 is applicable for examinations with only one to two views.
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The radiologic examination of the pelvis, coded as CPT® 72190, is indicated for various clinical scenarios where assessment of the pelvic region is necessary. The following conditions or symptoms may warrant this procedure:
The procedure for conducting a complete radiologic examination of the pelvis involves several key steps to ensure comprehensive imaging. The following outlines the procedural steps as described:
After the radiologic examination of the pelvis is completed, there are several considerations for post-procedure care. Patients may be advised to resume their normal activities unless otherwise directed by their healthcare provider. It is important for patients to follow any specific instructions provided regarding follow-up appointments or additional imaging if required. The images obtained will be interpreted by a radiologist, who will provide a report detailing the findings. This report will be essential for the referring physician to make informed decisions regarding further evaluation or treatment based on the results of the examination.
| Short Descr | X-RAY EXAM OF PELVIS | Medium Descr | RADIOLOGIC EXAM PELVIS COMPL MINIMUM 3 VIEWS | Long Descr | Radiologic examination, pelvis; complete, minimum of 3 views | 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 | ASC Payment Indicator | Packaged service/item; no separate payment made. | Type of Service (TOS) | 4 - Diagnostic Radiology | Berenson-Eggers TOS (BETOS) | I1B - Standard imaging - musculoskeletal | MUE | 1 | CCS Clinical Classification | 226 - Other diagnostic radiology and related techniques |
| 26 | Professional component: certain procedures are a combination of a physician or other qualified health care professional component and a technical component. when the physician or other qualified health care professional component is reported separately, the service may be identified by adding modifier 26 to the usual procedure number. | X5 | Diagnostic services requested by another clinician: for reporting services by a clinician who furnishes care to the patient only as requested by another clinician or subsequent and related services requested by another clinician; this modifier is reported for patient relationships that may not be adequately captured by the above alternative categories; reporting clinician service examples include but are not limited to, the radiologist's interpretation of an imaging study requested by another clinician | TC | Technical component; under certain circumstances, a charge may be made for the technical component alone; under those circumstances the technical component charge is identified by adding modifier 'tc' to the usual procedure number; technical component charges are institutional charges and not billed separately by physicians; however, portable x-ray suppliers only bill for technical component and should utilize modifier tc; the charge data from portable x-ray suppliers will then be used to build customary and prevailing profiles | GC | This service has been performed in part by a resident under the direction of a teaching physician | 59 | Distinct procedural service: under certain circumstances, it may be necessary to indicate that a procedure or service was distinct or independent from other non-e/m services performed on the same day. modifier 59 is used to identify procedures/services, other than e/m services, that are not normally reported together, but are appropriate under the circumstances. documentation must support a different session, different procedure or surgery, different site or organ system, separate incision/excision, separate lesion, or separate injury (or area of injury in extensive injuries) not ordinarily encountered or performed on the same day by the same individual. however, when another already established modifier is appropriate it should be used rather than modifier 59. only if no more descriptive modifier is available, and the use of modifier 59 best explains the circumstances, should modifier 59 be used. note: modifier 59 should not be appended to an e/m service. to report a separate and distinct e/m service with a non-e/m service performed on the same date, see modifier 25. | RT | Right side (used to identify procedures performed on the right side of the body) | LT | Left side (used to identify procedures performed on the left side of the body) | FY | X-ray taken using computed radiography technology/cassette-based imaging | XU | Unusual non-overlapping service, the use of a service that is distinct because it does not overlap usual components of the main service | FX | X-ray taken using film | XE | Separate encounter, a service that is distinct because it occurred during a separate encounter | 76 | Repeat procedure or service by same physician or other qualified health care professional: it may be necessary to indicate that a procedure or service was repeated by the same physician or other qualified health care professional subsequent to the original procedure or service. this circumstance may be reported by adding modifier 76 to the repeated procedure or service. note: this modifier should not be appended to an e/m service. | X4 | Episodic/focused services: for reporting services by clinicians who provide focused care on particular types of treatment limited to a defined period and circumstance; the patient has a problem, acute or chronic, that will be treated with surgery, radiation, or some other type of generally time-limited intervention; reporting clinician service examples include but are not limited to, the orthopedic surgeon performing a knee replacement and seeing the patient through the postoperative period | AQ | Physician providing a service in an unlisted health professional shortage area (hpsa) | 77 | Repeat procedure by another physician or other qualified health care professional: it may be necessary to indicate that a basic procedure or service was repeated by another physician or other qualified health care professional subsequent to the original procedure or service. this circumstance may be reported by adding modifier 77 to the repeated procedure or service. note: this modifier should not be appended to an e/m service. | GA | Waiver of liability statement issued as required by payer policy, individual case | Q6 | Service furnished under a fee-for-time compensation arrangement by a substitute physician or by a substitute physical therapist furnishing outpatient physical therapy services in a health professional shortage area, a medically underserved area, or a rural area | XP | Separate practitioner, a service that is distinct because it was performed by a different practitioner | 52 | Reduced services: under certain circumstances a service or procedure is partially reduced or eliminated at the discretion of the physician or other qualified health care professional. under these circumstances the service provided can be identified by its usual procedure number and the addition of modifier 52, signifying that the service is reduced. this provides a means of reporting reduced services without disturbing the identification of the basic service. note: for hospital outpatient reporting of a previously scheduled procedure/service that is partially reduced or cancelled as a result of extenuating circumstances or those that threaten the well-being of the patient prior to or after administration of anesthesia, see modifiers 73 and 74 (see modifiers approved for asc hospital outpatient use). | 58 | Staged or related procedure or service by the same physician or other qualified health care professional during the postoperative period: it may be necessary to indicate that the performance of a procedure or service during the postoperative period was: (a) planned or anticipated (staged); (b) more extensive than the original procedure; or (c) for therapy following a surgical procedure. this circumstance may be reported by adding modifier 58 to the staged or related procedure. note: for treatment of a problem that requires a return to the operating/procedure room (eg, unanticipated clinical condition), see modifier 78. | CC | Procedure code change (use 'cc' when the procedure code submitted was changed either for administrative reasons or because an incorrect code was filed) | CR | Catastrophe/disaster related | GP | Services delivered under an outpatient physical therapy plan of care | GV | Attending physician not employed or paid under arrangement by the patient's hospice provider | GW | Service not related to the hospice patient's terminal condition | 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 | GZ | Item or service expected to be denied as not reasonable and necessary | MG | The order for this service does not have applicable appropriate use criteria in the qualified clinical decision support mechanism consulted by the ordering professional | Q1 | Routine clinical service provided in a clinical research study that is in an approved clinical research study | Q5 | Service furnished under a reciprocal billing arrangement by a substitute physician or by a substitute physical therapist furnishing outpatient physical therapy services in a health professional shortage area, a medically underserved area, or a rural area | SA | Nurse practitioner rendering service in collaboration with a physician | XS | Separate structure, a service that is distinct because it was performed on a separate organ/structure |
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Notes
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| 2024-01-01 | Changed | One of the guidelines was removed. |
| 2009-01-01 | Changed | Code description changed |
| Pre-1990 | Added | Code added. |
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