Anesthesia Coding Alert

Question: How should I code an MRI of the elbow? The carrier rejected 24220 (Injection procedure for elbow arthrography) for the procedure.

Maryland Subscriber

Answer: Coding this case will depend on whether the physician used contrast. If the physician did not use contrast, you should code the procedure with 73221 (Magnetic resonance [e.g., proton] imaging, any joint of upper extremity; without contrast material[s]). If he or she used contrast, consider 73222 ( with contrast material[s]) or 73223 ( without contrast material[s], followed by contrast material[s] and further sequences) if appropriate. You could also use 24220 for the procedure for other carriers that might accept it.

If the doctor injected the contrast under fluoroscopy, use 76003 (Fluoroscopic guidance for needle placement [e.g., biopsy, aspiration, injection, localization device]) in addition to the primary procedure code. Report the radiological supervision and interpretation with 73085 (Radiologic examination, elbow, arthrography, radiological supervision and interpretation).

If the carrier requires anesthesia codes, use 01922 (Anesthesia for non-invasive imaging or radiation therapy).