Radiology Coding Alert

Question: If an MRI order is for "foot and ankle," should I bill these separately as joint codes or bill the foot as a lower extremity code?

Kentucky Subscriber

Answer: You should be able to report these with one joint code and one lower extremity code.

The CPT index points you to lower extremity codes 73718-73719 (Magnetic resonance [e.g., proton] imaging, lower extremity other than joint ...) for "MRI, foot" and joint codes 73721-73723 (Magnetic resonance [e.g., proton] imaging, any joint of lower extremity ...) for "MRI, ankle," but the answer is not always that simple.

Reporting a foot MRI depends on the study, according to the AMA and ACR's Clinical Examples in Radiology, Spring 2007. If the physician orders an ankle study, but the radiologist decides to expand the field of view to include more of the foot, you should only report the appropriate joint code (73721-73723), the article says. But if you have separate setups for each, you may report both a joint (73721-73723) and non-joint (73718-73720) code.

Remember: The codes you bill must match the ordered and, perhaps, precertified services.