How To Use CPT Code 73200

CPT 73200 refers to a computed tomography (CT) scan of the upper extremity without the use of contrast material. This article will cover the description, procedure, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information, similar codes, and examples of CPT 73200 procedures.

1. What is CPT 73200?

CPT 73200 is a medical billing code used to describe a computed tomography (CT) scan of the upper extremity without the use of contrast material. This diagnostic imaging procedure is performed to visualize and evaluate the bones, joints, and soft tissues of the upper extremity, which includes the shoulder, arm, elbow, forearm, wrist, and hand. The code is used by medical professionals to accurately document and bill for this specific type of CT scan.

2. 73200 CPT code description

The official description of CPT code 73200 is: “Computed tomography, upper extremity; without contrast material.”

3. Procedure

1. The patient is positioned on the CT scanner table, ensuring proper alignment and comfort.
2. The provider supervises the image acquisition as the scanner rotates around the patient’s upper extremity, capturing cross-sectional images without the use of contrast material.
3. Images are displayed on a monitor screen for the provider to review, analyze, and interpret.
4. The provider prepares a detailed report of their findings, which may include identification of any abnormalities or concerns related to the patient’s upper extremity.

4. Qualifying circumstances

Patients who are eligible to receive CPT 73200 services include those presenting with symptoms or conditions that require diagnostic imaging of the upper extremity. Examples of qualifying circumstances may include, but are not limited to:

• Suspected fractures or dislocations
• Joint or soft tissue injuries
• Chronic pain or inflammation
• Post-surgical evaluation
• Assessment of tumors or infections

5. When to use CPT code 73200

It is appropriate to bill CPT code 73200 when a provider performs a CT scan of the upper extremity without the use of contrast material for diagnostic purposes. This code should be used when the provider determines that a non-contrast CT scan is the most appropriate imaging modality to evaluate the patient’s specific symptoms or condition.

6. Documentation requirements

To support a claim for CPT 73200, the following information should be documented in the patient’s medical record:

• Indication for the CT scan, including relevant symptoms or conditions
• Details of the procedure, including patient positioning and image acquisition
• Provider’s interpretation and analysis of the images
• Findings and conclusions, including any identified abnormalities or concerns
• Recommendations for further evaluation or treatment, if applicable

7. Billing guidelines

When billing for CPT code 73200, it is important to follow established guidelines and rules to ensure accurate reimbursement. Some key points to consider include:

• Appending professional component modifier 26 to the radiology code when reporting only the physician’s interpretation of the radiology service
• Appending technical component modifier TC to the radiology code when reporting only the technical component of the radiology service
• Not appending a professional or technical modifier when reporting a global service in which one provider renders both the professional and technical components
• Using code 73201 for CT scans of the upper extremity with contrast material
• Checking individual payer policies for contrast coverage and reportable supply codes, if applicable

8. Historical information

CPT 73200 was added to the Current Procedural Terminology system on January 1, 1990. The code descriptor was changed on January 1, 2003, from “Computerized axial tomography, upper extremity; without contrast material” to its current description.

9. Similar codes to CPT 73200

Five similar codes to CPT 73200 and how they differ are:

• CPT 73201: This code is used for CT scans of the upper extremity with the use of contrast material.
• CPT 73202: This code is used for CT scans of the upper extremity with both contrast and non-contrast material.
• CPT 73218: This code is used for magnetic resonance imaging (MRI) of the upper extremity without contrast material.
• CPT 73219: This code is used for MRI of the upper extremity with contrast material.
• CPT 73220: This code is used for MRI of the upper extremity with both contrast and non-contrast material.

10. Examples

1. A patient presents with severe wrist pain after a fall. A CT scan without contrast (CPT 73200) is performed to evaluate for possible fractures or dislocations.
2. A patient with a history of chronic shoulder pain undergoes a non-contrast CT scan (CPT 73200) to assess for joint degeneration or soft tissue abnormalities.
3. A patient with a suspected infection in the elbow has a CT scan without contrast (CPT 73200) to visualize the extent of the infection and guide treatment planning.
4. A patient with a known tumor in the upper arm undergoes a non-contrast CT scan (CPT 73200) to monitor tumor size and progression.
5. A patient with a history of wrist surgery has a CT scan without contrast (CPT 73200) to evaluate post-surgical healing and hardware placement.
6. A patient with unexplained hand swelling and pain undergoes a non-contrast CT scan (CPT 73200) to assess for possible soft tissue injury or inflammation.
7. A patient with a suspected forearm fracture after a sports injury has a CT scan without contrast (CPT 73200) to confirm the diagnosis and guide treatment.
8. A patient with a history of chronic shoulder dislocations undergoes a non-contrast CT scan (CPT 73200) to evaluate joint stability and plan for possible surgical intervention.
9. A patient with a known infection in the hand has a CT scan without contrast (CPT 73200) to assess the extent of the infection and determine the need for surgical intervention.
10. A patient with a history of elbow surgery undergoes a non-contrast CT scan (CPT 73200) to evaluate post-surgical healing and hardware placement.