Wiki Shoulder Arthrogram Coding

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mjl903

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How would you code a shoulder arthrogram that is followed by MRI?
I know cpt code for the MRI is 73222
and the injection code is 23350,
however, should we code using 73040 or 77002?
and why did you choose this code?

Thank you!
 
Hi,
You would code 73040 if a radiographic study is done after the joint is injected. Our docs normally do internal and external rotation views but it could be other views. You would code 77002 (instead of 73040) when they use fluoro guidance to inject the joint and only a spot film is taken to verify contrast within the joint.

Shena
 
MR arthrogram shoulder

Code inj proc for sh 23350
Code Fluoro guidance for needle placement 77002
Code modality - MR UE w/ contrast 73222
obviously along w/ contrast used and any supplies

You cannot code both arthrography and fluoro guidance codes together
 
If you look in the cpt book under code 23350, underneath it it states "When fluroscopic guided injection is performed for enhanced mr arthrography, use 23350, 77002 and 73222. When they do the injection, do they just say the patient was injected with contrast and then transfered to mri? If so, code this with the above codes. Or does the rad talk about what he saw after the injection of the shoulder(diagnostic info) and then they transfer to mri? If so in this case, I would use 73040, 23350 and 73222.

Most of the times when they state that they did an "arthrogram" and then they send them for a mri, they really aren't doing an "arthrogram" but are just injecting the joint with contrast for the mri. It depends which scenario you have but most of the time you will be using the very first set of codes mentioned above (keep in mind if they do it under ultrasound guidance or ct guidance the 77002 will change to reflect which one it is).

Amber, CPC
 
What if the scenario is the injection is performed by a different physician? Can the -tc and -26 modifers be addended to the 23350?

One of our Pain physicians is doing work with an orthopedic group and will be doing these injections.
 
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