Radiology Coding Alert

Reader Question:

MRI Code Changes

Published on Thu Aug 01, 2002

Question: A colleague told me that coding for magnetic resonance arthrography of the shoulder has changed since last year. We have been using 23350 (Injection procedure for shoulder arthrography) and 73221 (Magnetic resonance [e.g., proton] imaging, any joint of upper extremity). Plus, we've been billing 76000 for fluoroscopic guidance. Are these correct?

Maine Subscriber

Answer: Your colleague is correct the fluoroscopy and MRI codes have changed from those you have been reporting. As of Jan. 1, 2001, your practice should have assigned the following codes in addition to 23350 (which has stayed the same and should still be coded and billed to report the injection service):

73222 Magnetic resonance [e.g., proton] imaging, any joint of upper extremity; with contrast material[s]

76003 Fluoroscopic guidance for needle placement (e.g., biopsy, aspiration, injection, localization device).

If the practice also performed a plain film shoulder arthrogram at the time of the injection by including iodinated contrast with the gadolinium, you should code 73040 instead of (but not in addition to) 76003. If the plain film arthrogram is not performed, then only the 76003 service may be coded for the fluoroscopic guidance for the needle placement and contrast injection. You may also report A4647 (Supply of paramagnetic contrast material [e.g., gadolinium]) for the contrast materials when billing for the technical services.