CPT Codes Guide - Healthcare

MRI CPT Codes

MRI (Magnetic Resonance Imaging) is used in radiology to find out any abnormalities inside the organ. It is a three dimensional scan using magnetic and radio waves to study any parts of the body including head or brain. MRI can detect few diseases (eg: prostate cancer, uterine cancer) which CT can not detect. A contrast or dye is used in MRI sometimes to improve the diagnostic accuracy.

MRI CPT Codes

MRI CPT Codes can be found in Radiology section of CPT book. All sets of codes are arranged based on the use of contrast material. Knowing anatomy and physiology will help in coding more accurate CPT and related ICD codes while coding for MRI.

Brain and head
CPT Code Description
70551 Without contrast material
70552  With contrast material
70553  With and without contrast material
70554 Functional MRI of brain not requiring physician or psychologist
70555 Functional MRI of brain requiring physician or psychologist
70557 MRI Brain during open surgery on brain : without contrast material
70558  : with contrast material
70559  : with and without contrast material

 

Upper extremity
CPT Code Description
73221 Joint : without contrast material
73222  : with contrast material
73223  : with and without contrast material
73218 Non –  joint: without contrast material
73219  : with contrast material
73220  : with and without contrast material

 

Lower extremity
CPT Code Description
73721 Joint : without contrast material
73722  : with contrast material
73723  : with and without contrast material
73718 Non- joint: without contrast material
73719  : with contrast material
73720  : with and without contrast material

 

Face and Neck
CPT Code Description
70336 MRI of TMJ joint
70540 MRI Face (orbit), neck : without contrast material
70542  : with contrast material
70543  : with and without contrast material

 

Abdomen
CPT Code Description
74181 Without contrast material
74182 With contrast material
74183 With and without contrast material

 

Chest and Cardiac
CPT Code Description
71550 Chest : Without contrast material
71551 With contrast material
71552 With and without contrast material
75565 Cardiac imaging : for velocity flow mapping
75557  : for morphology without contrast material
75559  : for morphology without contrast material, with stress imaging
75561  : for morphology with and without contrast material
75563  : for morphology with and without contrast material, with stress imaging

 

Pelvis
CPT Code Description
72195 Without contrast material
72196  With contrast material
72197  With and without contrast material

 

Spinal
CPT Code Description
Cervical
72141 Without contrast material
72142  With contrast material
72156  With and without contrast material
Lumbar
72148 Without contrast material
72149  With contrast material
72158  With and without contrast material
Thoracic
72146 Without contrast material
72147  With contrast material
72157  With and without contrast material

 

Breast
CPT Code Description
77046 Without contrast material, unilateral
77047 Without contrast material, bilateral
77048 With and without contrast material, unilateral
77049 With and without contrast material, bilateral

 

Blood
CPT Code Description
77084 MRI of bone marrow blood supply

 

Fetal MRI
CPT Code Description
74712 Single or first gestation
74713 Each additional gestation

 

Unlisted CPT
CPT Code Description
76498 Unlisted MRI

 

Guidelines:
  • Type of contrast material – When there is oral or rectal contrast used, it should be coded as “without contrast”. Only IV contrast is coded as “with contrast” as radiology services include both oral and rectal contrast.
  • CPT codes with and without contrast – Images taken without contrast followed by with contrast.
  • Do not use modifier 50 for bilateral services. Report in one line with 2 units or in two lines with modifier RT/LT
  • When provider orders for ankle study but radiologist does an expansion study to foot, it should be coded as joint (73721-73723). In the same scenario if there is setup for both study, code both joint and non-joint codes (73718-73720).
  • CPT 74713 is to be used for additional fetus as add on code with 74712. Use units with 74713 if the number of fetus is more than 2. Check MUE (medically unlikely edits) when applying units.
  • Apply NCD/LCD guidelines when coding ICDs with MRI codes.
  • Check applicable modifiers with each CPT.
MRI Coding Tips:
  • Check for the anatomical site of MRI before reviewing other details in the report.
  • Read carefully to find out if any discrepancies in contrast material
  • Do not miss to check the number of fetus when coding CPT 74712.
  • Number of units allowed should be checked when coding CPTs with units.
  • It is easy to find the correct code if the report is read thoroughly.
 MRI CPT Codes Example:

59 year old Elizabeth is referred by Dr.Janet for MRI abdomen.

Type of Exam – MRI Abdomen with intravenous and oral contrast

Clinical History – 36 year old female with breast cancer undergoing chemotherapy, here with new onset of abdominal pain suspects cancer.

Technique – 1.5 T MR images of entire abdomen was observed after IV contrast and oral contrast.

Findings – Stomach: – No mass or abnormality found. Bowel:-No wall thickening or dilation. Liver:-Normal size. Gall Bladder: – within normal limits. Pancreas: – No ductal dilation or mass found. Spleen:-No splenomegaly. Bladder: – within normal limits. Kidney: – No mass found.

Impression – No abnormal findings on MRI to account for abdominal pain or probable cancer.

CPT coding for this scenario:

74182 – R10.9

Note: As there is IV contrast used the CPT code can be used “with contrast”.