How To Use CPT Code 73221

CPT 73221 is a diagnostic procedure code for magnetic resonance imaging (MRI) of any joint in the upper extremity 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 73221 procedures.

1. What is CPT 73221?

CPT 73221 is a diagnostic procedure code used for magnetic resonance imaging (MRI) of any joint in the upper extremity without the use of contrast material. This code is utilized when a healthcare provider performs an MRI to visualize and diagnose conditions affecting the joints of the upper extremity, such as the shoulder, elbow, wrist, or joints of the hand.

2. 73221 CPT code description

The official description of CPT code 73221 is: “Magnetic resonance (eg, proton) imaging, any joint of upper extremity; without contrast material(s)”.

3. Procedure

1. The patient is positioned on the scanning table, and the upper extremity joint to be examined is placed within the MRI scanner.
2. The patient is instructed to remain still and hold their breath while the images are taken.
3. The MRI scanner generates a strong magnetic field and radiofrequency signals, which are captured by the computer to create detailed images of the joint.
4. The healthcare provider reviews the images, analyzes the findings, and interprets the results.
5. A written report of the findings is prepared by the provider.

4. Qualifying circumstances

Patients who are eligible to receive CPT code 73221 services are those with suspected or confirmed conditions affecting the joints of the upper extremity, such as arthritis, joint injuries, or other joint disorders. The MRI procedure should be deemed medically necessary by the healthcare provider to diagnose, manage, or treat the patient’s condition.

5. When to use CPT code 73221

It is appropriate to bill the 73221 CPT code when a healthcare provider performs an MRI of any joint in the upper extremity without the use of contrast material. This code should be used when the MRI is necessary for the diagnosis, management, or treatment of a patient’s condition affecting the upper extremity joint.

6. Documentation requirements

To support a claim for CPT 73221, the following information should be documented:

• Patient’s medical history and presenting symptoms
• Physical examination findings related to the upper extremity joint
• Indication for the MRI procedure and its medical necessity
• Details of the MRI procedure, including the joint examined and the absence of contrast material
• Findings, analysis, and interpretation of the MRI images
• Written report of the findings and any recommendations for further evaluation or treatment

7. Billing guidelines

When billing for CPT code 73221, 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, do not append a professional or technical modifier when reporting a global service in which one provider renders both components.

8. Historical information

CPT 73221 was added to the Current Procedural Terminology system on January 1, 1990. The code was changed on January 1, 2001, with the previous descriptor being “Magnetic resonance (eg, proton) imaging, any joint of upper extremity”.

9. Similar codes to CPT 73221

Five similar codes to CPT 73221 and how they differ are:

• 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
• 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 73220: MRI of the upper extremity, excluding joints, without contrast material followed by contrast material and further sequences

10. Examples

1. MRI of the shoulder joint without contrast material to evaluate rotator cuff tears
2. MRI of the elbow joint without contrast material to assess for ligament injuries
3. MRI of the wrist joint without contrast material to diagnose carpal tunnel syndrome
4. MRI of the hand joints without contrast material to evaluate rheumatoid arthritis
5. MRI of the shoulder joint without contrast material to assess for labral tears
6. MRI of the elbow joint without contrast material to diagnose osteoarthritis
7. MRI of the wrist joint without contrast material to evaluate for scaphoid fractures
8. MRI of the hand joints without contrast material to assess for joint dislocations
9. MRI of the shoulder joint without contrast material to diagnose adhesive capsulitis
10. MRI of the elbow joint without contrast material to evaluate for synovitis