# MRI foot,lower leg & femur



## pscalici (May 22, 2014)

Need help, if a MRI foot, lower leg and femur w/o ordered and scanned separately, can you charge for 3 CPT 73718 with modifier 59 on them or can you only charge for 1 lower extremity no matter how much of the leg is done?
Thanks in advance.


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## mhstrauss (May 22, 2014)

pscalici said:


> Need help, if a MRI foot, lower leg and femur w/o ordered and scanned separately, can you charge for 3 CPT 73718 with modifier 59 on them or can you only charge for 1 lower extremity no matter how much of the leg is done?
> Thanks in advance.



73718 x 1 for the lower leg and femur.  CPT description is "lower extremity, other than joint", which would include thigh to ankle long bones.  There is no separation of the code for "upper leg" and "lower leg".

73721 x 1 for the foot, "joint of lower extremity".

Should not need mod 59, as these 2 codes are not inclusive of each other.

Hope this helps!


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## pscalici (May 22, 2014)

The foot is a joint?  Would it not go under extremity.  I thought the ankle, knee & hip were the joints.


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## Tonyj (May 22, 2014)

pscalici said:


> Need help, if a MRI foot, lower leg and femur w/o ordered and scanned separately, can you charge for 3 CPT 73718 with modifier 59 on them or can you only charge for 1 lower extremity no matter how much of the leg is done?
> Thanks in advance.



73718, 73718-59, 73721 but if its MCR or some of the other carriers you'll only get full payment on 1 all others will be paid at a reduced rate.


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## pscalici (May 22, 2014)

*MRI foot, lower leg & femur*

I am confused on the MRI foot.  In the CPT book if you look up foot , MRI it directs you to 73718.  I am thinking that it should be (3) 73718's.


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## Tonyj (May 23, 2014)

pscalici said:


> I am confused on the MRI foot.  In the CPT book if you look up foot , MRI it directs you to 73718.  I am thinking that it should be (3) 73718's.



You are absolutely right! I stand corrected. It should be (3) 73718 with (2) 59modifiers.


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## mhstrauss (May 26, 2014)

I stand corrected also; I'm used to seeing 73721 for foot...we don't do many extremity MRI's in my clinic, but the few that are done are more targeted to the joints of the foot, so we use the "joint" CPT code.

However, I'm still not seeing how you can use 3 units of 73718.  The CPT description is "extremity"...not "segment of extremity", which would allow one unit for each individual segment.  Is there official guidance on this?  I checked CPT Assistant, but I'm not finding anything there.


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## jbrightw (May 27, 2014)

73718 can be used only once for an extremity (Not a segment). So this case should be billed with 73718 only.

Jesus Brightwin


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## Tonyj (May 27, 2014)

jbrightw said:


> 73718 can be used only once for an extremity (Not a segment). So this case should be billed with 73718 only.
> 
> Jesus Brightwin



I beg to differ. When doing those particular procedures for a MRI the tech would need to scan 3 different areas. The radiologist would dictate a report for each individual area. Some codes in the radiology section of the CPT break out the number of views etc. This code does not. I would bill all 3 codes. The tech has to perform 3 different scans which in and of itself does take a considerable amount of time as well as the radiologist.
Just my 2 cents.


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## mhstrauss (May 27, 2014)

Tonyj said:


> I beg to differ. When doing those particular procedures for a MRI the tech would need to scan 3 different areas. The radiologist would dictate a report for each individual area. Some codes in the radiology section of the CPT break out the number of views etc. This code does not. I would bill all 3 codes. The tech has to perform 3 different scans which in and of itself does take a considerable amount of time as well as the radiologist.
> Just my 2 cents.



I understand this point of view, as I've had this same conversation with my rad techs, but that is irrelevant when considering the CPT definition of 73718, which specifically states "extremity", not "segment of extremity" or "1 unit per scan".


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## mitchellde (May 27, 2014)

I have to agree with Meagan that is billed only one time with 1 unit.  They do not perform different scans with the MRI they perform one scan and have scanner do multiple slices.  There is no repositioning of the patient.  There is no rationale for charging for 3 scans when only one is performed.


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## Tonyj (May 27, 2014)

mitchellde said:


> I have to agree with Meagan that is billed only one time with 1 unit.  They do not perform different scans with the MRI they perform one scan and have scanner do multiple slices.  There is no repositioning of the patient.  There is no rationale for charging for 3 scans when only one is performed.



Again, I beg to differ with you Debra. I've worked in a MRI facility and for each scan there was a different coil placement for that specific body area. Depending on the body area being scanned and the strength of the magnet it could take anywhere from 20 minutes plus for each area. The patient is pulled from the machine each time and the coil placed on the area being scanned. We charged for each area being scanned. A common denial for duplicative claims but paid after submitting the report showing the different body areas. i.e. MRI humerus and radius/ulna 73218 x2 w modifier 59.


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## bnmoody (Aug 12, 2016)

*MRI Extremity - Joint/Nonjoint*

If the patient has a MRI Joint you can code *multiple* studies (Upper: 73221-73223) (Lower: 73721-73723). 

Non-joint studies are to be reported *once* per extremity (Upper: 73218-73220) (Lower:73718-73720).

Upper Extremity Joint: Shoulder, Elbow, Wrist
Lower Extremity Joint: Hip, Knee, Ankle

Upper Extremity Non-Joint: Humerus, Forearm, Hand
Lower Extremity Non-Joint: Thigh, Lower Leg, Foot

Joint Example: LT Ankle, LT Knee, LT Hip you can charge for 3 studies with LT and 59x2 modifiers
Non-joint Example: LT Thigh, LT Lower Leg you can charge for 1 study with LT modifier

I hope this helps!!


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## brieck41 (Jul 9, 2021)

bnmoody said:


> *MRI Extremity - Joint/Nonjoint*
> 
> If the patient has a MRI Joint you can code *multiple* studies (Upper: 73221-73223) (Lower: 73721-73723).
> 
> ...


i go by this chart above, can you tell me where you got this from?


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