CPT Codes-Modifiers-ICD10 Codes

CPT Codes

X-Rays

70030 – eye for foreign body

70110 – jaw complete

70160 – nasal bones

70200 – orbits

70260 – skull complete

70328 – jaw joint unilateral

70330 – jaw joint bilateral

70360 – neck soft tissue

71010 – chest 1 view

71101 – ribs unilateral 3 view

71111 – ribs bilateral 4 view

71120 – sternum 3 view

72010 – entire spine AP/LAT

72020 – spine 1 view

72040 – C spine 2 or 3 view

72050 – C spine 4 view

72052 – C spine with flex/ext 

72069 – thoracic lumbar standing

72070 – thoracic spine 2 view

72072 – thoracic spine 3 view

72074 – thoracic spine 4 view

72080 – thoracolumbar 2 view

72090 – trunk spine scoliosis study

72100 – Lower spine 2 or 3 view

72110 – lower spine 4 view

72114 – lumbar complete bending

72120 – lumbosacral bending only

72190 – pelvis complete

72200 – sacroiliac joints bilat 1v

72202 – sacroiliac joints 3 views

72220 – sacrum/coccyx

73000 – clavicle

73010 – scapula

73020 – shoulder 1 view

73030 – shoulder 2 view

73050 – AC joints bilateral

73060 – humerus

73070 – elbow 2 views

73080 – elbow complete

73090 – forearm

73100 – wrist 2 view

73110 – wrist complete

73120 – hand/1st CMC joint 2v

73130 – hand/1st CMC joint 3v

73140 – fingers

73501 – hip/pelvis unilateral

73502 – hip/pelvis unilateral 2 v

73521 – hips/pelvis bilateral 2 v

73522 – hip/pelvis bilat 4 view

73523 – hip/pelvis bilat 5 view

73540 – hip/pelvis infant or child

73551 – femur 1 view

73552 – femur 2 view

73560 – knee 1 or 2 view

73562 – knee 3 view

73564 – knee 4 view

73590 – lower leg tibia

73600 – ankle 2 view

73610 – ankle complete

73620 – foot 2 view

73630 – foot complete

73650 – heel 2 view

73660 – toes

77072 – bone age

77073 – bone length study

77074 – bone survey limited

77075 – bone survey complete

77077 – joint survey 1 view

Procedure CPT Codes

27369 – Arthrogram Knee

23350 – Arthrogram Shoulder

27093 – Arthrogram Hip

20551 – Tendon Block

20552 – TPI 1-2 muscle groups

20553 – TPI 3 muscle groups

64405 – Occipital Nerve Block

64418 – Suprascapular Nerve Block

64445 – Sciatic Nerve Block

64454 – Genicular Nerve Block

20610 – Intraarticular/Bursa

20611 – Intraarticular/Bursa w/US

0232T – PRP

38206 – Stem Cell Adipose

S2142 – Stem Cell Umbilical or Exosomes

PRPTX – Wellness PRP

CELTX – Wellness IV Stem

FDATR – FDA Trial Patients

J2001 – Lidocaine

S0020 – Marcaine

Q9966 – Contrast

J3301 – Kenalog 10mg

J7320 – Genvisc (25 units)

J7321 – Hyalgan (1 unit)

J7323 – Euflexxa (1 unit)

J7325 – Synvisc (16 units)

J7325 – Synvisc 1 (48 units)

J7329 – Trivisc (25 units)

77002 – Fluoroscopic Guidance Extremity

77003 – Fluoroscopic Guidance Spine

76942 – Ultrasound guidance

97140 – Astym if performed prior to injection procedure

97750 – Safe Balance Assessment, Qty 2, Bill with modifier “GP”

Facet Injections

Cervical – Dx M47.812

64490 (1 level)

64491 (2 levels)

64492 (3 levels)

∙ + mod 50 if bilateral

∙ Must document Lt vs Rt

If doing a 3rd level document Lt vs Rt

Lumbar – Dx M47.817

64493 (1 level)

64494 (2 level)

64495 (3 level)

∙ + mod 50 if bilateral

∙ Must document Lt vs Rt

If doing 3rd level document Lt vs Rt

E/M codes

New Patient

99201 – straight forward decision making, exam of single body area

99202 – straight forward decision making, problem pertinent exam

99203 – low complexity decision making, extended history and ROS, extended exam

99204 – moderate complexity decision making, extended history and ROS, complete single system or complete multi-system exam (*Most common new Pt code)

99205 – High complexity decision making, extended history, complete ROS, with complete multi-system exam

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E/M codes

Current Patient

99211 – minimal history and exam

99212 – straight forward decision making, problem pertinent exam

99213 – low complexity decision making, extended history and ROS, extended exam

99214 – moderate complexity decision making, extended ROS, extended exam

99215 – high complexity decision making, complete ROS, complete exam or multi-system exam

Modifiers

25 – use with E/M when significant, separately identifiable service by same provider on same day is performed. (tpi or injection done with exam)

RT – Right side, Laterality used in extremity injections

LT – Left Side, Laterality used in extremity injections

50 – Bilateral, used in extremity and some spine injections

 

All E/M codes require Chief complaint and HPI.

HPI must address,

O-onset,

P-palliative or provocative signs

Q-quality of pain

R-radiation

S-severity (pain scale)

T-timing,

TX-previous treatment and response.

Procedure Superbills

Trigger Points

  1. 20552 or 20553 – Injection, 1-2 muscles or >3 muscles

  2. 76942 – U/S Guidance

  3. J2001 – Lidocaine

  4. S0020 – Bupivicaine 

Tendon Blocks

  1. 20551 – Tendon Block

  2. 76942 – U/S Guidance

  3. J2001 – Lidocaine

  4. S0020 – Bupivicaine 

Visco

  1. 20610 – Arthrocentesis Major Joint

  2. 77002 – Fluoroscopic Guidance Needle Placement

  3. Q9966 – Contrast

  4. J2001 – Lidocaine

  5. J7320 or J7321 or J7323 or J7325 – Viscosupplement

Large Joint Injection

  1. 20610

  2. 77002

  3. Q9966

  4. J2001

  5. S0020

Lumbar Facet Injection – M47.817

  1. 64493 – 1st Level

  2. 64494 – 2nd Level

  3. 64495 (if 3rd level performed)

  4. 77003 – Spine Fluoro

  5. J2001

  6. S0020

Cervical Facet Injection – M47.812

  1. 64490 – 1st Level

  2. 64491 – 2nd Level

  3. 64492 – (if 3rd level performed)

  4. 77003

  5. J2001

  6. S0020

SI Joint Injection – M46.1

  1. 27096 – SI Joint Inj

  2. 77003 – Spine Fluoro

  3. J2001

  4. S0020

PRP

  1. 0232T

 

Stem Cell Adipose

  1. 38206

  2. 0232T

Stem Cell Allogeneic

  1. S2142

PRP for Dept of Labor pts

  1. P9020

Wellness PRP

  1. PRPTX

Wellness Cellular Therapy

CELTX

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