CPT code 72141

(2022) CPT Code 72141 – Cervical Spine MRI (Description, Guidelines & Reimbursement)

CPT code 72141 is used to report for service when MRI (Magnetic Resonance Imaging) of the cervical spine is performed without using contrast. The MRI is a radiation-free procedure, painless and not harmful like CT (Computed Tomographic) scans.

CPT Code 72141 Description

CPT code 72141 provides high-quality visualization of the cervical spine in multiple planes inside the body. It will aid in identifying the problem of the soft tissue of the neck, bones, abnormal vertebrae, joint disorders, aneurysm, birth defects, deformities, scoliosis, degenerated and herniated discs of the cervical spine.

Each image is considered a slice, and more than 100 images are captured during a complete MRI scan of the cervical spine. The images are then placed in the computer and visualized in a 3D space to focus and diagnose the problem.

MRI of the cervical spine uses magnetic properties that produce radiation when this radiation signal reflects with a high-electric magnetic field, resulting in 3D high-resolution images. Therefore, MRI would not be done on patients with metallic implants or foreign bodies. 

The patient can be sedated to remain still in the large circular tunnel, and contrast can be used to enhance the image or visualization. MRI of the cervical spine is performed three ways. The first way is to be performed without contrast which will be reported with CPT 72141.

The second is to be performed with a contrast medium for better visualization of the cervical spine (CPT 72142). The third is to utilize both ways with and without contrast medium reported by CPT code 72156.

CPT 72141 will be reported for MRI of the cervical spine without contrast when performed by the physician, which includes spinal canal and contents of spine

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CPT Code 72141 Reimbursement

A maximum of 1 unit of CPT code 72141 can be billed on the same date of service, while three units can be billed if documentation supports the medical necessity. Modifier 26 and TC apply to this CPT 71250 for reimbursement purposes. The cost and RUVs of CPT 72141 are as follows:

CPT 72141 with modifier 26: (Facility Price: Cost $77.73 RUVS 2.24610) (Non-Facility Price: Cost $77.73 RUVS 2.24610)

CPT 72141 with modifier TC (Technical Component): (Facility Price: Cost $157.89 RUVS 4.56239) (Non-Facility Price: Cost $157.89 RUVS 4.56239)

CPT code 72141 Global price (Without 26 and TC): (Facility Price: Cost $235.62 RUVS 6.80849 Non-Facility Price: Cost $235.62 RUVS 6.80849)

Billing Guidelines

CPT code 72141 has technical and professional components. Therefore, it should be billed with an appropriate 26 or TC modifier. However, if the physician owns the practice, these modifiers TC and 26 are not required.

Documentation should support the medical necessity of service and be medically appropriate. The appropriate ICD 10 codes should be reported to the claims for reimbursement. The most billed dx codes are M41, M50, M47, etc. In addition, there are specific codes for each cervical region C1 – C7 and pick the most specified dx codes.

If intrathecal injection CPT codes are reported with CPT code 72141, it is appropriate to bill with separate CPT codes 61055 and 62284. 

Radiology services are typically performed without anesthesia then. Therefore, it is appropriate to bill with CPT code 01922.

If contrast is injected in combination with MRI cervical spine code, then it is appropriate to report with HCPCS level 2 codes A9575–A9579, A9581, A9585, and Q9953–Q9954. While CPT code 72141 is performed without contrast. Therefore, there is no need to report these codes with CPT code 72141.

If contrast is injected via any other route such as intrathecal except intravenous or intraarticular route will be not considered as contrast study, then it appropriate to bill with non-contrast CPT code 72141 instead 72142 with contrast codes.

If both contrast and non-contrast study of the cervical spine is performed on the same day, then it is reported with combination code 72156 instead of CPT 72141 and 72142 on the same day.

CPT code 72141 is allowed to be billed together on the same date of service as CPT code 72156 according to NCCI (National Correct Coding Initiative). Therefore, only CPT 72156 will be reported due to higher pay.

The 3D imaging is included in the MRI cervical spine CPT code 72141, and there is no need to report separately. 

If MR spectroscopy (0609T-0610T) is performed in combination with CPT code 71250, it is not appropriate to bill separately according to NCCI. Only CPT code 72141 will be billed due to higher pay.

If physicians perform an MRI of the cervical spine without contrast and are not visible and the same physician performs MRI with contrast, it is an appropriate bill with COT code 72156.

While if the different physician performs a contrast study, then it is appropriate to report with two different CPT codes, e.g., MRI cervical spine without contrast will be bellied with CPT 72141 for Physician A, and MRI cervical spine with contrast will be bellied with modifier 77 with CPT code 72142.

Modifiers

The following is a list of modifiers that are applicable with CPT code 72141:

  • 22, 23, 26, 51, 52, 53, 59, 76, 77, 78, 79, 99, AQ, AI, AR, CC, CR, ET, EY, FX, FY, GA, GC, GJ, GK, GR, GU, GY, GZ, KX, Q5, Q6, QJ, QQ, SG, TC, XE, XS, XP, and XU.

The most frequently used modifiers are 26, TC, 77, 76, 59, or X {E, P, S, U} with CPT 72141. Modifier 26 is used to indicate the professional services or equipment and applicable with CPT 72141 when the physician in a hospital performs an MRI of the Cervical spine or does not own the equipment used in the Cervical spine or employee in the Facility.

At the same time, modifier TC is used to indicate technical components such as machinery used in MRI Cervical spine CPT 72141. It would be reported by Hospital or third party who owned the equipment.

CPT 72141 will be globally billed when an MRI of the Cervical spine is performed in a private office, or a physician owns the equipment. Globally billed means without modifier 26 or TC. 

If an MRI of the Cervical spine is performed twice by the same physician on the same date of service, then CPT 72141 would be reported with Modifier 76, while MRI of the Cervical spine performed by a different physician on the same day it appropriate to attach modifier 77 with CPT 72141.

Modifier 59 is applicable with CPT 72141 when service is not normally performed together on the same date of service but bundled with other procedures. For further specifications, Medicare accepts modifiers XU, XE, XP, and XS instead of modifier 59 with CPT 72141.

Modifier Q6 is applicable with CPT 72141 for locum tenants billing or temporary substitute physicians. Suppose the radiologist is on leave or absent from an original physician. In that case, services are provided by the temporary physician or substitute physician with modifier Q6 under the name of the original provider, not with Loum tenant. 

Modifier 53 applies to CPT 72141 when the physician terminates the procedure due to unavoidable circumstances and plans to repeat the procedure in the future. In contrast, modifier 52 will be attached to the CPT 72141 if the procedure is performed incompletely by the physician and does not plan to repeat the procedure.

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CPT 72141 Examples

The following examples are when CPT 72141 may be used.

Example 1

A 60-year-old female presented to the office with cervicalgia for four days. The pain gets worse with movement and when lying down. The patient took some medication for pain. The patient denies any other symptoms such as headache, numbness, urinary problems, nausea, vomiting, shortness of breath.

Physical exam revealed swelling in the neck region. The physician ordered CT cervical spine, and it is revealed that degeneration of cervical spine at C1 – C2, C3 – C4 and disk budging at the C4-C5 level.

The patient also has spondylosis of the cervical spine. The physician prescribed medicine for pain and treatment and suggested a follow-up every two weeks. 

Example 2

A 16-year-old male presented to the emergency department after a motor vehicle accident today and had a severe headache, neck pain, chest pain. The patient is unable to move his neck and has severe pain. The patient denies urinary symptoms, extremity pain, dizziness.

Physical exam revealed neck and eye swelling. The physician ordered a CT of the neck, head, and chest. The patient had multiple fractures of C1-C2 and C3-C4 and ribs. The physician ordered fracture splinting and consulted orthopedics for patients’ current condition and treatment.

Example 3 

A 39-year-old male with PMH of thyroid cancer presents to the emergency department with c/o constant neck pain that started four days ago. The patient was unable to eat anything for 1-week. The patient is consulted with his primary care physician and suggested to go emergency department.

Denies trauma, heavy palpitations, dizziness, cough, recent illness, fever, chills, back pain, abdominal pain, nausea, recent travel, known sick contacts, recent antibiotic use, near-syncope or syncope, changes in stool color, urinary complaints, or any other symptoms. The patient took his routine medication.

The physician ordered a CT scan of the soft tissues of the neck and laboratory studies if cancer is back. CT neck revealed that multiple thyroid nodules and biopsies were sent to labs to check if it was benign or malignant.

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