Radiology Coding Alert

Question: The radiologist performed a magnetic resonance imaging (MRI) on a patient’s right shoulder, confirming osteolysis in the impression. I am vaguely familiar with osteolysis and its treatment, but could you explain how to report this encounter?

California Subscriber

Answer: First, check out your coding options, followed by a brief primer on the ins and outs of osteolysis.

CPT^® coding: You’ll choose one of the following codes for the MRI, depending on use of contrast:

• 73221 (Magnetic resonance (eg, proton) imaging, any joint of upper extremity; without contrast material(s))
• 73222 (… with contrast material(s))
• 73223 (… without contrast material(s), followed by contrast material(s) and further sequences)

Remember: Do not report from code range 73218-73220 (Magnetic resonance (eg, proton) imaging, upper extremity, other than joint…) when the exam indicates it was performed on the shoulder.

Modifier: Be sure to append modifier RT (Right side) to the MRI code you choose to indicate laterality.

ICD-10 coding: Append M89.511 (Osteolysis, right shoulder) to the MRI code to represent the patient’s osteolysis.

Background: According to Dorland’s Medical Dictionary, osteolysis is the “dissolution of bone; applied especially to the removal or loss of the calcium of bone.”