CPT code 72100 refers to a radiologic examination of the lumbosacral spine with two or three views. It is often the first imaging step when patients report lower back pain, injury, or other spinal concerns.
The 72100 CPT code description includes capturing lateral and anteroposterior (AP) views for basic evaluation.
What does CPT code 72100 mean? It indicates that imaging has been performed for diagnostic purposes on the lower spine using standard radiologic equipment
Billing for 72100 CPT codes is usually done by:
These providers must ensure clinical necessity and proper documentation for accurate billing.
The following facilities are typically included when billing this procedure code:
The code does not include contrast or follow-up CT/MRI services, which are billed separately (e.g., MRI lumbar spine w/o contrast CPT code).
CPT code 72100 is not time-dependent like E/M codes. Instead, the billing depends on the number of radiographic views taken (2-3 views minimum) and proper documentation.
If fewer than two views are captured, the code may not be applicable.
Does CPT code 72100 need a modifier?
Yes, depending on the billing context:
Reimbursement varies by payer and region. On average:
These values may change based on payer contracts, use of modifiers, and facility location.
CPT Code | Description |
72100 | Lumbosacral spine X-ray, 2-3 views |
72110 | Lumbosacral spine X-ray, minimum 4 views |
72114 | Complete lumbar spine study with bending views |
72120 | Lumbosacral spine with oblique views |
Knowing when to use 72100 vs. 72110 helps avoid overbilling or underreporting.
CPT code 72100 plays a crucial role in the diagnostic workflow for spine evaluations. It’s a foundational imaging procedure that requires clear documentation and proper modifier use for full reimbursement. Missteps, like forgetting to add modifiers or billing with incomplete views, can lead to denials.
As a billing service provider, we advise staying up to date with AMA coding updates and payer-specific requirements to ensure smooth claims processing.
Disclaimer: This content is for informational purposes only and does not constitute legal, billing, or medical advice. Always refer to the latest AMA CPT Guidelines and payer rules for accuracy.
CPT code 72100 is used for radiologic imaging of the lumbosacral spine using two or three views, commonly for evaluating lower back pain.
Yes, use Modifier 26 for the professional component and Modifier TC for the technical component when billing separately.
Medicare reimburses approximately $35–$50, while private payers may reimburse $50–$75 depending on the region and payer.
Not, the billing is constructed on the number of views (2–3 views), not the time consumed performing the procedure.
72100 is for 2–3 views of the spine, while 72110 covers a more comprehensive study with at least 4 views.
Yes, if inside their possibility of practice and correctly documented for medical necessity, chiropractors may bill 72100.
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