Radiology Coding Alert

Question: An 8-year-old pediatric patient was brought to a radiology practice by their parents. The patient experienced a fall at home and was complaining of elbow pain after the incident. Elbow X-rays didn’t reveal a fracture, so the patient’s pediatrician ordered an MRI to check for damage to the ligaments or tendons.

I know there are specific procedure codes for children, but are there any codes for pediatric MRIs?

Colorado Subscriber

Answer: The CPT^® code set does not currently have separate magnetic resonance imaging (MRI) codes for pediatric patients. Instead, you’ll need to choose from one of the following MRI codes for the situation you posed:

• 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)

Your code selection depends on whether the provider administered contrast material during the imaging procedure. You’ll assign 73222 if the radiologist used contrast to examine the body structures, but you’ll assign 73221 if the radiologist performed the MRI without administering contrast. However, if the documentation shows the radiologist performed the MRI without contrast, then administered contrast, and captured more images, then you’ll assign 73223.

Important: According to CPT^® guidelines preceding the Radiology chapter, the use of contrast material(s) only applies to contrast administered intra-articularly (into the joint), intrathecally (into the spinal canal), or intravascularly (into the blood vessel). If the documentation lists “oral contrast,” then you will assign 73221 for the procedure.