# ? correct CPT for MRI brachial plexus/axilla



## Kimberley (Apr 17, 2009)

Order:  MRI OF LEFT AXILLA (BRACHIAL PLEXUS)  DX: R/O GROWTH OF LEFT AXILLA   W/WO CONTRAST

Report:

MRI OF THE LEFT BRACHIAL PLEXUS AND AXILLA WITHOUT AND WITH INTRAVENOUS 
GADOLINIUM:CLINICAL INDICATION:  Pain, numbness and tingling left upper extremity and pain in the 
back. There is question of palpable mass within the left axilla.TECHNIQUE:  Multiplanar, multisequence MRI of the left axilla and left brachial plexus 
were performed, before and following the intravenous administration of 15 cc of 
gadolinium.  IV access was obtained on site. Vitamin E marker was placed on the skin in 
the area of palpable concern as indicated by the patient.FINDINGS:  On precontrast images, T2 and T2-weighted images, there is no MR definable 
mass, near area of palpable concern. Of note, there is prominent fat in that location but 
no encapsulation, to suggest the presence of a focal lipoma. There is no visible axillary 
adenopathy.  There is no mass, supraclavicular. The brachial plexus, demonstrates normal 
signal intensity and contour. There is no increased signal within the nerves on inversion 
recovery imaging.The glenohumeral alignment is grossly maintained on the left. There is no definite MR 
evidence of acute fracture.  The visualized portion of the mediastinum is unremarkable. The visualized thyroid gland is 
grossly unremarkable.  Post-gadolinium administration, there is normal enhancement, in the left subclavian vein, 
and left subclavian and axillary arteries.  There is no abnormal enhancement, or 
enhancing mass seen.
IMPRESSION: 1.  Normal MR examination of the left brachial plexus and left axilla. No mass is identified. 
Clinical followup is advised.  Negative MR examination should not deter biopsy of a clinically suspicious palpable 
finding.

Insurance approved 73223 and we billed it out as 71552???

HELP!!!! Is the axilla/brachial plexus really considered a joint?


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## Radcoder1313 (Apr 17, 2009)

According to the ACR (bulletin, Feb 2001), the chest can be coded when doing a brachial plexus scan to identify apical lung cancers (found CSI Navigator).  I have coded brachial plexus scans this way also, but most of the time, they tend to fall under upper extremity non-joint (73218) based on the reporting details.  I've never personally coded one as a joint.  Hope that helps a little.


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## Kimberley (Apr 20, 2009)

Other opinions???

Thanks.

Kimberley Tober, CPC
Franklin, TN


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