How To Use CPT Code 73218

CPT 73218 is a diagnostic procedure code for magnetic resonance imaging of the upper extremity, excluding joints, without contrast material. 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 73218 procedures.

1. What is CPT 73218?

CPT 73218 is a diagnostic procedure code used for magnetic resonance imaging (MRI) of the upper extremity, excluding joints, without the use of contrast material. This code is utilized by medical coders and billers to accurately report and bill for this specific type of MRI procedure.

2. 73218 CPT code description

The official description of CPT code 73218 is: “Magnetic resonance (eg, proton) imaging, upper extremity, other than joint; without contrast material(s)”.

3. Procedure

1. The patient is positioned on the scanning table, with their upper extremity inside the MRI scanner.
2. The patient is instructed to hold their breath and remain still while images are taken.
3. The MRI scanner generates a strong magnetic field, capturing radiofrequency signals from the patient’s body.
4. A computer processes the signals and generates a series of images displaying slices of the upper extremity.
5. The provider reviews the images, analyzes, and interprets the results.
6. A written report of the findings is prepared by the provider.

4. Qualifying circumstances

Patients eligible to receive CPT 73218 services are those who require an MRI of their upper extremity, excluding joints, for diagnostic purposes. This may include patients with suspected soft tissue injuries, tumors, or other abnormalities in the upper extremity that require further investigation. The MRI must be performed without the use of contrast material.

5. When to use CPT code 73218

It is appropriate to bill the 73218 CPT code when a provider performs an MRI of the upper extremity, excluding joints, without contrast material. This code should be used for diagnostic purposes when investigating suspected soft tissue injuries, tumors, or other abnormalities in the upper extremity.

6. Documentation requirements

To support a claim for CPT 73218, the following information should be documented:

• Patient’s medical history and reason for the MRI
• Physical examination findings
• Details of the MRI procedure, including the area imaged and the absence of contrast material
• Provider’s interpretation of the MRI results
• Written report of the findings

7. Billing guidelines

When billing for CPT 73218, consider the following guidelines:

• Append professional component modifier 26 to the radiology code if reporting only the physician’s interpretation of the radiology service.
• Append modifier TC to the radiology code if reporting only the technical component of the radiology service. Note that payer policy may exempt hospitals from appending modifier TC.
• 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.
• Check individual payers’ policies for contrast coverage and reportable supply codes if the provider supplies contrast material.

8. Historical information

CPT 73218 was added to the Current Procedural Terminology system on January 1, 2001. There have been no updates to the code since its addition.

9. Similar codes to CPT 73218

Five similar codes to CPT 73218 and how they differ are:

• CPT 73219: MRI of the upper extremity, excluding joints, with contrast material.
• CPT 73220: MRI of the upper extremity, excluding joints, without contrast material followed by contrast material and additional sequences.
• CPT 73221: MRI of any joint of the upper extremity without contrast material.
• CPT 73222: MRI of any joint of the upper extremity with contrast material.
• CPT 73223: MRI of any joint of the upper extremity, first without contrast material, followed by contrast material and further sequences.

10. Examples

Here are 10 detailed examples of CPT code 73218 procedures:

1. A patient with a suspected soft tissue injury in the forearm undergoes an MRI without contrast to assess the extent of the injury.
2. An MRI without contrast is performed on a patient with a history of a tumor in the upper arm to monitor for recurrence.
3. A patient with unexplained pain and swelling in the upper extremity undergoes an MRI without contrast to investigate the cause.
4. An MRI without contrast is performed on a patient with a suspected infection in the soft tissues of the upper extremity.
5. A patient with a history of nerve compression in the upper extremity undergoes an MRI without contrast to evaluate the current status of the nerves.
6. An MRI without contrast is performed on a patient with a suspected vascular abnormality in the upper extremity.
7. A patient with a history of a complex fracture in the upper extremity undergoes an MRI without contrast to assess bone healing and alignment.
8. An MRI without contrast is performed on a patient with a suspected muscle tear in the upper extremity.
9. A patient with a suspected ganglion cyst in the upper extremity undergoes an MRI without contrast to confirm the diagnosis.
10. An MRI without contrast is performed on a patient with a suspected ligament injury in the upper extremity.