How To Use CPT Code 73222

CPT 73222 refers to a diagnostic procedure involving magnetic resonance imaging (MRI) of any joint in the upper extremity with 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 73222 procedures.

1. What is CPT 73222?

CPT 73222 is a diagnostic procedure code used to describe magnetic resonance imaging (MRI) of any joint in the upper extremity, such as the shoulder, elbow, wrist, or joints of the hand, with the use of contrast material. This procedure is performed to obtain detailed images of the joint structures, which can help diagnose various conditions and guide treatment decisions.

2. 73222 CPT code description

The official description of CPT code 73222 is: “Magnetic resonance (eg, proton) imaging, any joint of upper extremity; with 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 magnetic field of the MRI scanner.
2. The patient is instructed to hold their breath and remain still while the images are taken.
3. Contrast material is injected to enhance the image quality.
4. The MRI scanner captures radiofrequency signals generated by the body, and a computer generates a series of images displaying slices of the targeted joint.
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 who are eligible to receive CPT code 73222 services include those with suspected or confirmed joint abnormalities, injuries, or diseases in the upper extremity. Examples of qualifying circumstances may include joint pain, swelling, limited range of motion, suspected fractures, ligament or tendon injuries, arthritis, or tumors. The provider must determine that an MRI with contrast is medically necessary for the patient’s specific condition and that other imaging modalities, such as X-ray or ultrasound, are insufficient for accurate diagnosis.

5. When to use CPT code 73222

It is appropriate to bill the 73222 CPT code when a provider performs an MRI of any joint in the upper extremity with the use of contrast material, and the procedure is medically necessary for the patient’s specific condition. The provider must ensure that the patient meets the qualifying circumstances and that proper documentation is maintained to support the claim.

6. Documentation requirements

To support a claim for CPT 73222, the provider must document the following information:

• Medical necessity for the MRI with contrast, including the patient’s specific condition and symptoms
• Qualifying circumstances that justify the use of CPT code 73222
• Details of the procedure, including the joint examined, contrast material used, and any complications or adverse reactions
• Findings and interpretation of the MRI images
• A written report of the findings and any recommendations for further evaluation or treatment

7. Billing guidelines

When billing for CPT code 73222, providers should be aware of the following guidelines:

• Append professional component modifier 26 to the radiology code when reporting only the physician’s interpretation of the radiology service.
• Append modifier TC to the radiology code when reporting only the technical component for the radiology service. 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.
• Check individual payers’ policies for contrast coverage and reportable supply codes. Providers who supply contrast may also separately report the contrast using a 99070 supply code or a HCPCS Level II code.

8. Historical information

CPT 73222 was added to the Current Procedural Terminology system on January 1, 2001. The code descriptor was changed on January 1, 2002, to include “with contrast material(s)”.

9. Similar codes to CPT 73222

Five similar codes to CPT 73222 and how they differentiate are:

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

10. Examples

Here are 10 detailed examples of CPT code 73222 procedures:

1. A patient with a history of rheumatoid arthritis presents with worsening pain and swelling in the wrist joint. An MRI with contrast is performed to assess joint damage and guide treatment decisions.
2. A patient with a suspected rotator cuff tear undergoes an MRI with contrast to evaluate the extent of the injury and determine the appropriate course of treatment.
3. An athlete with a history of recurrent shoulder dislocations undergoes an MRI with contrast to assess the integrity of the joint structures and plan for possible surgical intervention.
4. A patient with persistent elbow pain and limited range of motion undergoes an MRI with contrast to evaluate for possible ligament or tendon injuries.
5. A patient with a suspected ganglion cyst in the wrist joint undergoes an MRI with contrast to confirm the diagnosis and plan for possible surgical removal.
6. A patient with a history of osteoarthritis in the shoulder joint undergoes an MRI with contrast to assess the severity of joint degeneration and determine the need for joint replacement surgery.
7. A patient with a suspected fracture in the elbow joint that is not clearly visible on X-ray undergoes an MRI with contrast to confirm the diagnosis and guide treatment decisions.
8. A patient with a history of a previous wrist surgery presents with new-onset pain and swelling in the joint. An MRI with contrast is performed to evaluate for possible complications or recurrent issues.
9. A patient with a suspected tumor in the shoulder joint undergoes an MRI with contrast to assess the size, location, and characteristics of the mass and plan for possible biopsy or surgical intervention.
10. A patient with a history of chronic instability in the wrist joint undergoes an MRI with contrast to evaluate the joint structures and determine the need for surgical stabilization.