How To Use CPT Code 72159

CPT 72159 describes the diagnostic procedure of magnetic resonance angiography (MRA) for the evaluation of blood vessels in the spinal canal and its contents. This article will provide an overview of CPT 72159, including its official description, procedure, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information, and similar codes.

1. What is CPT Code 72159?

CPT 72159 is a code used to describe the diagnostic procedure of magnetic resonance angiography (MRA) for the evaluation of blood vessels in the spinal canal and its contents. This procedure involves the use of magnetic resonance imaging (MRI) to generate detailed images of the arteries and veins in the spinal canal, allowing healthcare providers to assess for stenosis or aneurysm in these blood vessels.

2. Official Description

The official description of CPT code 72159 is: ‘Magnetic resonance angiography, spinal canal and contents, with or without contrast material(s).’ This procedure involves the use of MRI to visualize the blood vessels in the spinal canal and its contents, and contrast material may be used to enhance the images if necessary.

3. Procedure

1. During the procedure, the patient is positioned on a scanning table, which slides into a large tunnel-shaped magnetic scanner.
2. The magnetic field generated by the scanner allows for the visualization of the blood vessels in the spinal canal.
3. If necessary, contrast material may be injected into the patient’s blood vessels to enhance the images.
4. The provider captures the radiofrequency signals generated by the body, and a computer generates a series of images that display the vascular structure of the spinal canal and its contents.
5. The provider reviews the images, analyzes them, and interprets the results.
6. A written report is prepared, documenting the findings of the MRA procedure.

4. Qualifying circumstances

CPT 72159 is typically performed when there is a suspicion of stenosis or aneurysm in the blood vessels of the spinal canal. This procedure may be ordered for patients who present with symptoms such as back pain, numbness, or weakness in the limbs, or for those who have a history of vascular abnormalities. The use of contrast material may be necessary to enhance the visualization of the blood vessels during the MRA procedure.

5. When to use CPT code 72159

CPT code 72159 should be used when a healthcare provider performs a magnetic resonance angiography (MRA) of the blood vessels in the spinal canal and its contents. This code is appropriate when the MRA procedure is performed with or without the use of contrast material. It is important to note that CPT code 72159 should not be reported if the MRA procedure is performed on other areas of the body, such as the brain or extremities.

6. Documentation requirements

To support a claim for CPT code 72159, the healthcare provider must document the following information:

• Indication for the MRA procedure, including the suspected diagnosis or reason for evaluation
• Whether contrast material was used during the procedure
• Any specific findings or abnormalities observed during the MRA
• Interpretation and analysis of the images by the provider
• A written report documenting the findings of the MRA procedure

7. Billing guidelines

When billing for CPT code 72159, it is important to ensure that the procedure performed is specifically for the evaluation of blood vessels in the spinal canal and its contents. This code should not be reported if the MRA procedure is performed on other areas of the body. If only the physician’s interpretation is being reported, the professional component modifier 26 should be appended to the CPT code. If only the technical component is being reported, the modifier TC should be appended. However, it is important to review payer policies as hospitals may be exempt from appending modifier TC. Additionally, if contrast material is separately supplied, it may be separately reported using the appropriate supply code or HCPCS Level II code, depending on payer guidelines.

8. Historical information

CPT code 72159 was added to the Current Procedural Terminology system on January 1, 1994. There have been no updates or changes to the code since its addition.

9. Examples

1. A patient with suspected spinal stenosis undergoes an MRA procedure of the spinal canal and its contents to evaluate the blood vessels in that area.
2. A patient with a known history of aneurysm in the spinal canal undergoes an MRA procedure to monitor the condition and assess any changes in the blood vessels.
3. A patient presents with symptoms of numbness and weakness in the lower limbs, and an MRA of the spinal canal is performed to evaluate the blood vessels for any abnormalities.
4. A healthcare provider orders an MRA procedure of the spinal canal and its contents for a patient with chronic back pain to assess for any vascular causes of the pain.
5. A patient with a suspected vascular malformation in the spinal canal undergoes an MRA procedure to visualize the blood vessels and confirm the diagnosis.