How To Use CPT Code 73220

CPT 73220 is a diagnostic procedure involving magnetic resonance imaging (MRI) of the upper extremity, excluding joints, with and without 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 73220 procedures.

1. What is CPT 73220?

CPT 73220 is a diagnostic procedure code used for magnetic resonance imaging (MRI) of the upper extremity, excluding joints, performed with and without contrast material. This code is used by medical coders and billers to report the service provided by healthcare professionals when performing this specific type of MRI.

2. 73220 CPT code description

The official description of CPT code 73220 is: “Magnetic resonance (eg, proton) imaging, upper extremity, other than joint; without contrast material(s), followed by contrast material(s) and further sequences.”

3. Procedure

1. The patient is positioned on the scanning table, and the upper extremity is placed within the MRI scanner.
2. The patient is instructed to hold their breath and remain still during the imaging process.
3. Initial images of the upper extremity are taken without the use of contrast material.
4. Contrast material is then administered via injection to enhance image quality.
5. Additional images are taken after the contrast material has been administered.
6. The healthcare provider reviews and analyzes the images, interpreting the results.
7. A written report of the findings is prepared by the provider.

4. Qualifying circumstances

Patients who are eligible to receive CPT code 73220 services are those requiring an MRI of the upper extremity, excluding joints, for diagnostic purposes. This may include patients with suspected or confirmed injuries, diseases, or abnormalities affecting the upper extremity, such as fractures, tumors, or vascular issues. The healthcare provider must determine that an MRI with and without contrast material is necessary for accurate diagnosis and treatment planning.

5. When to use CPT code 73220

It is appropriate to bill the 73220 CPT code when a healthcare provider performs an MRI of the upper extremity, excluding joints, with and without contrast material. This code should be used when the provider determines that the use of contrast material is necessary for accurate diagnosis and treatment planning, and when the procedure is performed for diagnostic purposes.

6. Documentation requirements

To support a claim for CPT 73220, the following information should be documented:

• Patient’s medical history and reason for the MRI
• Specific area of the upper extremity being imaged
• Details of the MRI procedure, including the use of contrast material
• Findings and interpretation of the MRI images
• Written report of the findings, including any diagnoses or treatment recommendations

7. Billing guidelines

When billing for CPT code 73220, it is important to follow the appropriate guidelines and rules. If only the physician’s interpretation of the radiology service is being reported, modifier 26 should be appended to the radiology code. If only the technical component of the radiology service is being reported, modifier TC should be appended to the radiology code. However, payer policy may exempt hospitals from appending modifier TC, as 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.

8. Historical information

CPT 73220 was added to the Current Procedural Terminology system on January 1, 1990. There have been changes to the code descriptor on January 1, 2001, and January 1, 2002.

9. Similar codes to CPT 73220

Five similar codes to CPT 73220 and how they differentiate are:

• CPT 73218: MRI of the upper extremity, excluding joints, without contrast material.
• CPT 73219: MRI of the upper extremity, excluding joints, with contrast material.
• 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 73220 procedures:

1. A patient with a suspected soft tissue tumor in the forearm undergoes an MRI with and without contrast to determine the extent of the tumor.
2. An individual with a history of vascular issues in the upper extremity undergoes an MRI with and without contrast to assess blood flow and identify any abnormalities.
3. A patient with unexplained pain and swelling in the upper arm undergoes an MRI with and without contrast to identify any underlying issues.
4. An individual with a suspected fracture in the forearm that is not clearly visible on X-ray undergoes an MRI with and without contrast for further evaluation.
5. A patient with a history of nerve compression in the upper extremity undergoes an MRI with and without contrast to assess the current state of the nerves and surrounding structures.
6. An individual with a suspected infection in the soft tissues of the upper arm undergoes an MRI with and without contrast to determine the extent of the infection and guide treatment planning.
7. A patient with a history of a previous surgical repair in the upper extremity undergoes an MRI with and without contrast to assess the integrity of the repair and identify any complications.
8. An individual with a suspected muscle tear in the upper arm undergoes an MRI with and without contrast to confirm the diagnosis and guide treatment planning.
9. A patient with unexplained numbness and tingling in the upper extremity undergoes an MRI with and without contrast to identify any underlying issues affecting the nerves or blood vessels.
10. An individual with a history of a complex injury to the upper extremity undergoes an MRI with and without contrast to assess the healing process and identify any complications or issues requiring further intervention.