Radiology Coding Alert

Question: Should I report 73721 once or twice for bilateral hip MRI?

Answer: You should indicate the performance of two exams. You should base how you indicate the performance of two exams on your payer's reporting preference.

In an article affirming that 73721 (Magnetic resonance [e.g., proton] imaging, any joint of lower extremity; without contrast material) is the appropriate code for a hip MRI without contrast, CPT Assistant (June 2006) states that modifier 50 (Bilateral procedure) is not recommended for bilateral radiology exams.

Instead: The article suggests listing the radiology code twice on the claim form, but acknowledges that payers will differ in their preferences. Possibilities include appending modifiers RT (Right side) and LT (Left side) to your codes, or reporting a one-line entry with a 2 in the units field.

Watch contrast: Remember that your hip MRI code choice will vary based on the use of contrast. Report 73721 for MRI without contrast, 73722 (...with contrast material[s]) for MRI with contrast, and 73723 (... without contrast material[s], followed by contrast material[s] and further sequences) for hip MRI scans performed without contrast and then performed with contrast.