How To Use CPT Code 72146

CPT 72146 is a diagnostic procedure code for magnetic resonance imaging (MRI) of the thoracic spinal canal and contents without contrast. This article will cover the description, procedure, qualifying circumstances, when to use the code, documentation requirements, billing guidelines, historical information, similar codes, and examples of CPT 72146 procedures.

1. What is CPT 72146?

CPT 72146 is a diagnostic procedure code used for magnetic resonance imaging (MRI) of the thoracic spinal canal and contents without the use of contrast material. This code is used by medical coders and billers to report the specific MRI procedure performed on a patient for diagnostic purposes.

2. 72146 CPT code description

The official description of CPT code 72146 is: “Magnetic resonance (eg, proton) imaging, spinal canal and contents, thoracic; without contrast material.”

3. Procedure

The 72146 procedure involves the following steps:

  1. The patient is positioned on the scanning table, which slides into a large tunnel-shaped magnetic scanner.
  2. The patient’s body is exposed to a strong magnetic field and radio waves to visualize the thoracic spinal canal and contents.
  3. The patient is instructed to hold their breath and remain still while the thoracic images are taken.
  4. The provider captures the radiofrequency signals generated by the patient’s body, and a computer generates a series of images displaying slices of the thoracic spine.
  5. The provider reviews the images, analyzes the results, and interprets the findings.
  6. A written report of the findings is prepared by the provider.

4. Qualifying circumstances

Patients eligible to receive CPT code 72146 services are those who require a diagnostic MRI of the thoracic spinal canal and contents without contrast material. This may include patients with suspected or confirmed spinal disorders, injuries, or diseases that require further evaluation and diagnosis. Examples of qualifying circumstances may include, but are not limited to, spinal stenosis, disc herniation, tumors, infections, or degenerative changes in the thoracic spine.

5. When to use CPT code 72146

It is appropriate to bill the 72146 CPT code when a provider performs a diagnostic MRI of the thoracic spinal canal and contents without the use of contrast material. This code should be used when the provider determines that an MRI without contrast is the most appropriate diagnostic tool for the patient’s specific condition and clinical presentation.

6. Documentation requirements

To support a claim for CPT 72146, the following information should be documented:

  • Patient’s medical history and clinical presentation, including symptoms and physical examination findings.
  • Indication for the MRI, including the suspected or confirmed diagnosis that warrants the imaging study.
  • Details of the MRI procedure, including the specific area imaged (thoracic spinal canal and contents) and the fact that no contrast material was used.
  • Provider’s interpretation of the MRI findings, including any identified abnormalities or relevant findings related to the patient’s condition.
  • A written report of the MRI findings, signed by the interpreting provider.

7. Billing guidelines

When billing for CPT code 72146, keep in mind the following guidelines:

  • If reporting only the physician’s interpretation for the radiology service, append professional component modifier 26 to the radiology code.
  • If reporting only the technical component for the radiology service, append modifier TC to the radiology code. Note that payer policy may exempt hospitals from appending modifier TC because the hospital’s portion is inherently technical.
  • Do not append a professional or technical modifier to the radiology code when reporting a global service in which one provider renders both the professional and technical components.
  • When the provider administers oral or rectal contrast, code the service as without contrast because the radiology service includes oral and rectal contrast.
  • To assign a code whose descriptor includes contrast, the contrast must be intravascular, intraarticular, or intrathecal.
  • Depending on the payer’s guidelines, providers who supply contrast may also separately report the contrast using a 99070 supply code or a HCPCS Level II code. Check individual payers’ policies for contrast coverage and reportable supply codes.

8. Historical information

CPT 72146 was added to the Current Procedural Terminology system on January 1, 1990. There have been no updates to the code since its addition.

9. Similar codes to CPT 72146

Five similar codes to CPT 72146 and how they differentiate are:

  • CPT 72141: This code is for an MRI of the cervical spinal canal and contents without contrast material.
  • CPT 72147: This code is for an MRI of the thoracic spinal canal and contents with contrast material.
  • CPT 72148: This code is for an MRI of the lumbar spinal canal and contents without contrast material.
  • CPT 72156: This code is for an MRI of the entire spinal canal and contents, including cervical, thoracic, and lumbar regions, without and with contrast material.
  • CPT 72158: This code is for an MRI of the lumbar spinal canal and contents without and with contrast material.

10. Examples

Here are 10 detailed examples of CPT code 72146 procedures:

  1. A 45-year-old patient with a history of thoracic spinal stenosis presents with worsening back pain and numbness in the lower extremities. The provider orders an MRI of the thoracic spinal canal and contents without contrast to evaluate the severity of the stenosis.
  2. A 60-year-old patient with a history of thoracic disc herniation presents with new onset of radicular pain. The provider orders an MRI of the thoracic spinal canal and contents without contrast to assess the herniation and any potential nerve compression.
  3. A 50-year-old patient with a history of thoracic spine trauma presents with persistent pain and limited mobility. The provider orders an MRI of the thoracic spinal canal and contents without contrast to evaluate for any structural abnormalities or injuries.
  4. A 55-year-old patient with a history of thoracic spine infection presents with recurrent fever and back pain. The provider orders an MRI of the thoracic spinal canal and contents without contrast to assess for any residual infection or complications.
  5. A 65-year-old patient with a history of thoracic spine degenerative changes presents with worsening back pain and stiffness. The provider orders an MRI of the thoracic spinal canal and contents without contrast to evaluate the progression of the degenerative changes.
  6. A 40-year-old patient with a history of thoracic spine tumor presents with new onset of pain and neurological symptoms. The provider orders an MRI of the thoracic spinal canal and contents without contrast to assess the tumor size and any potential nerve or spinal cord compression.
  7. A 70-year-old patient with a history of thoracic spine surgery presents with recurrent pain and limited mobility. The provider orders an MRI of the thoracic spinal canal and contents without contrast to evaluate the surgical site and any potential complications.
  8. A 35-year-old patient with a history of thoracic spine inflammatory disease presents with worsening pain and stiffness. The provider orders an MRI of the thoracic spinal canal and contents without contrast to assess the extent of the inflammation and any potential complications.
  9. A 30-year-old patient with a history of thoracic spine congenital abnormality presents with new onset of pain and neurological symptoms. The provider orders an MRI of the thoracic spinal canal and contents without contrast to evaluate the abnormality and any potential nerve or spinal cord compression.
  10. A 20-year-old patient with a history of thoracic spine sports injury presents with persistent pain and limited mobility. The provider orders an MRI of the thoracic spinal canal and contents without contrast to assess for any structural abnormalities or injuries.

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