Neurology & Pain Management Coding Alert

Question: What is the difference between a magnetic resonance imaging (MRI) test and a magnetic resonance angiography of the spinal canal and contents? Would I use the same codes to report both services?

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Answer: You should not code MRIs and magnetic resonance angiographies of the spinal canal and its contents with the same codes. They are different procedures, and you should treat them as such. Check out this quick summary of both procedures.

MRI definition: An MRI of the spinal canal and its contents occurs when the provider visualizes body tissues using magnetic fields and radio waves; she does this in order to manage, diagnose, or treat injury/disease.

MRI coding: MRI coding is very specific; for the spinal canal, you’ll choose from the following codes, depending on encounter details:

• 72141 (Magnetic resonance (eg, proton) imaging, spinal canal and contents, cervical; without contrast material) or 72142 ( … with contrast material(s)).
• 72146 (Magnetic resonance (eg, proton) imaging, spinal canal and contents, thoracic; without contrast material) or 72147 ( … with contrast material(s)).
• 72148 (Magnetic resonance (eg, proton) imaging, spinal canal and contents, lumbar; without contrast material) or 72149 ( … with contrast material(s)).
• 72156 (Magnetic resonance (eg, proton) imaging, spinal canal and contents, without contrast material, followed by contrast material(s) and further sequences; cervical), 72157 ( … thoracic), or 72158 ( … lumbar).

Magnetic resonance angiography definition: Basically, a magnetic resonance angiography is an MRI that the provider conducts on the blood vessels rather than on body tissues. These procedures are necessary if the provider suspects stenosis or an aneurysm of the vessels.

Magnetic resonance angiography coding: Code choice for this service is straightforward. Regardless of the spinal area, you’ll report 72159 (Magnetic resonance angiography, spinal canal and contents, with or without contrast material(s)) for the angiography.