# MRI Guided Arthrogram Left Shoulder



## ItsUp2U (Jan 26, 2012)

I have a question for how to correctly code a MRI Guided Arthrogram LT Shoulder

23350 Arthrogram, 73222 contrast materials, and 77021 MRI guidance?

Other than LT, are there any other modifiers needed?

Thanks in advance,
Tricia


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## donnajrichmond (Jan 27, 2012)

Tbergen777 said:


> I have a question for how to correctly code a MRI Guided Arthrogram LT Shoulder
> 
> 23350 Arthrogram, 73222 contrast materials, and 77021 MRI guidance?
> 
> ...



If an MRI guided injection of contrast into the shoulder joint was done followed by MR with contrast, then the only other modifier you might need is 26 on the 2 70000 codes if you are billing for a physician who did this at the hospital.  There are no CCI edits for these codes. 
Was the injection really done under MR guidance?  or fluoro? I'm a little leery about coding both 77021 and 73222.  I would tend more toward NOT coding 77021.  
Other opinions?


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## ItsUp2U (Jan 27, 2012)

donnajrichmond said:


> If an MRI guided injection of contrast into the shoulder joint was done followed by MR with contrast, then the only other modifier you might need is 26 on the 2 70000 codes if you are billing for a physician who did this at the hospital.  There are no CCI edits for these codes.
> Was the injection really done under MR guidance?  or fluoro? I'm a little leery about coding both 77021 and 73222.  I would tend more toward NOT coding 77021.
> Other opinions?



It was not done under fluoro, the report read MR Guidance.  Thanks!


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## dpeoples (Jan 27, 2012)

Tbergen777 said:


> It was not done under fluoro, the report read MR Guidance.  Thanks!





Dr Z's materials from last september (webinar) conveniently skipped/omitted this scenario...hmmm

23350 is certainly correct and as of now, billing for an MRI guided (77021) MRI of the shoulder (73222) is permitted  but it seems odd to me as well. Don't be surprised if this changes later this year.

HTH


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