Summary & Overview
CPT 72220: X-ray of Sacrum and Coccyx, Minimum Two Views
CPT code 72220 denotes a diagnostic radiographic exam of the sacrum and coccyx with a minimum of two views to assess fractures, swelling, or pain in the lower back and tailbone region. Nationally, this code is central to initial imaging for trauma and chronic coccygeal pain and informs subsequent clinical management such as immobilization, referral, or advanced imaging. Key payers in the national landscape include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare.
This publication provides benchmarks and clinical context for use of CPT code 72220, summarizes common payer coverage considerations, and highlights coding context relevant to diagnostic radiology service lines. Readers will find an overview of typical settings where the service is delivered (outpatient radiology, hospital radiology suites, ambulatory imaging centers), expected clinical indications reflected by the procedure description, and guidance on where to look for payer-specific policies. Data not available in the input is noted where applicable. The content is intended for a national audience of billing managers, radiology departments, and payers seeking a concise reference on the role and application of CPT code 72220 in diagnostic workflows.
Billing Code Overview
CPT code 72220 describes radiologic examination of the sacrum and coccyx with at least two views. This imaging procedure is used to evaluate fractures, swelling, degenerative changes, or sources of lower back and tailbone pain.
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Service type: Diagnostic radiology (plain film X-ray)
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Typical site of service: Outpatient radiology departments, hospital radiology suites, and ambulatory imaging centers
Clinical & Coding Specifications
Clinical Context
A 45-year-old patient presents to the emergency department after a fall onto the buttocks with focal lower sacral pain and difficulty sitting. The triage nurse documents localized pain over the coccyx and sacrum without neurologic deficits. The emergency physician performs a focused musculoskeletal and neurologic exam and orders imaging to evaluate for fracture, dislocation, or focal bony abnormality. A radiology technologist obtains at least two plain radiographic views of the sacrum and coccyx using 72220 to visualize the osseous alignment and detect acute fractures or degenerative change. The images are interpreted by a radiologist who communicates findings—such as coccygeal fracture, sacral insufficiency fracture, or no acute osseous injury—to the treating provider, who documents results in the ED record and plans conservative management, immobilization, or orthopedic referral as indicated.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
26 | Professional component | Use when billing only the interpreting physician's professional component for the radiographic interpretation separate from the technical service. |
TC |