How To Use CPT Code 74181

CPT 74181 refers to magnetic resonance imaging (MRI) of the abdomen 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 74181 procedures.

1. What is CPT 74181?

CPT 74181 is a medical billing code used to describe a specific type of diagnostic imaging procedure, specifically magnetic resonance imaging (MRI) of the abdomen without the use of contrast material. This noninvasive diagnostic imaging study helps physicians to visualize and assess the structures and organs within the abdomen, providing valuable information for diagnosing and treating various medical conditions.

2. 74181 CPT code description

The official description of CPT code 74181 is: “Magnetic resonance (eg, proton) imaging, abdomen; without contrast material(s)”.

3. Procedure

  1. The patient is asked not to eat or drink for a few hours before the test.
  2. The patient is placed on the scanning table.
  3. The technician who operates the machine will be in another room and always able to watch or hear the patient during the exam.
  4. The scanning table slides the whole body into a large tunnel-shaped magnetic scanner so that the patient’s abdomen is inside a strong magnetic field.
  5. The technician instructs the patient to hold their breath and stay still for 10 to 15 seconds while the images are taken.
  6. During the test, the MRI makes a rapid tapping noise. To mask this noise, earplugs are provided to the patient.
  7. The technician captures the radiofrequency signals generated by the body, and the computer generates a series of images that display slices of the target area.
  8. Pictures from an MRI scan are digital images that are displayed on the computer screen.
  9. The images are then reviewed by the radiologist, who performs a diagnostic interpretation.
  10. The physician prepares a written report of their findings.

4. Qualifying circumstances

Patients who are eligible to receive CPT code 74181 services are those who require an MRI of the abdomen without contrast material for diagnostic purposes. This may include patients with suspected or confirmed abdominal conditions, such as tumors, infections, or structural abnormalities. The decision to perform an MRI without contrast material is typically based on the patient’s medical history, symptoms, and the physician’s clinical judgment.

5. When to use CPT code 74181

It is appropriate to bill the 74181 CPT code when an MRI of the abdomen is performed without the administration of contrast material. This may be due to the patient’s medical condition, contraindications to contrast material, or the physician’s determination that contrast material is not necessary for the specific diagnostic purpose. The use of CPT code 74181 should be supported by the patient’s medical record and the physician’s documentation of the rationale for performing the MRI without contrast material.

6. Documentation requirements

To support a claim for CPT 74181, the following information should be documented in the patient’s medical record:

  • Indication for the MRI, including the patient’s symptoms, medical history, and any relevant physical examination findings.
  • Reason for performing the MRI without contrast material, such as contraindications or the physician’s clinical judgment.
  • Details of the MRI procedure, including the date, time, and location of the exam.
  • Radiologist’s diagnostic interpretation of the MRI images, including any identified abnormalities or findings.
  • Physician’s written report summarizing the MRI findings and their clinical significance.

7. Billing guidelines

When billing for CPT code 74181, it is important to follow the appropriate guidelines and rules to ensure accurate reimbursement. Some key points to consider include:

  • Use modifier 26 to indicate the professional component of the radiology service if reporting only the physician’s interpretation.
  • Use modifier TC to indicate the technical component of the radiology service if reporting only the technical component. 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.

8. Historical information

CPT 74181 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, abdomen”.

9. Similar codes to CPT 74181

There are several similar codes to CPT 74181, which differ based on the use of contrast material and the specific area of the body being imaged. These include:

  • CPT 74182: MRI of the abdomen with contrast material.
  • CPT 74183: MRI of the abdomen initially without contrast material, followed by injection of contrast and additional sequences.
  • CPT 72195: MRI of the pelvis without contrast material.
  • CPT 72196: MRI of the pelvis with contrast material.
  • CPT 72197: MRI of the pelvis initially without contrast material, followed by injection of contrast and additional sequences.

10. Examples

  1. A patient with a history of abdominal pain and weight loss undergoes an MRI of the abdomen without contrast material to evaluate for possible malignancy.
  2. A patient with a known liver lesion undergoes an MRI of the abdomen without contrast material for follow-up imaging and assessment of lesion stability.
  3. An MRI of the abdomen without contrast material is performed to evaluate a patient with suspected Crohn’s disease and bowel inflammation.
  4. A patient with a history of kidney stones undergoes an MRI of the abdomen without contrast material to assess for the presence of additional stones.
  5. An MRI of the abdomen without contrast material is performed to evaluate a patient with suspected abdominal aortic aneurysm.
  6. A patient with a history of pancreatitis undergoes an MRI of the abdomen without contrast material for follow-up imaging and assessment of pancreatic tissue.
  7. An MRI of the abdomen without contrast material is performed to evaluate a patient with suspected gallbladder disease and gallstones.
  8. A patient with a known adrenal mass undergoes an MRI of the abdomen without contrast material for follow-up imaging and assessment of mass stability.
  9. An MRI of the abdomen without contrast material is performed to evaluate a patient with suspected spleen enlargement and possible hematologic disorder.
  10. A patient with a history of abdominal trauma undergoes an MRI of the abdomen without contrast material to assess for organ injury and internal bleeding.

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