How To Use CPT Code 73221

CPT 73221 describes the diagnostic procedure of performing a magnetic resonance imaging (MRI) of any joint in the upper extremity without the use of contrast material. This article will cover the description, official details, procedure, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information, similar codes and billing examples.

1. What is CPT Code 73221?

CPT 73221 can be used to describe the diagnostic procedure of conducting an MRI of any joint in the upper extremity without the administration of contrast material. This code is utilized when a healthcare provider uses magnetic fields and radio waves to visualize the tissues in the patient’s shoulder, elbow, wrist, or hand joints.

2. Official Description

The official description of CPT code 73221 is: ‘Magnetic resonance (eg, proton) imaging, any joint of upper extremity; without contrast material(s).’ This code specifically refers to the performance of an MRI on the joints of the upper extremity without the use of contrast material.

3. Procedure

1. The healthcare provider positions the patient’s upper extremity, which may include the shoulder, elbow, wrist, or hand, within the MRI scanner.
2. The patient is instructed to hold their breath and remain still while the images are captured.
3. The MRI scanner generates a series of images using magnetic fields and radio waves, providing a visual representation of the targeted joint.
4. The healthcare provider reviews and analyzes the images to interpret the results.
5. A written report is prepared by the provider, documenting their findings from the MRI scan.

4. Qualifying circumstances

CPT 73221 is applicable when a patient requires a diagnostic MRI of any joint in the upper extremity without the use of contrast material. This procedure is typically performed to diagnose, manage, and treat various diseases or conditions affecting the joints of the shoulder, elbow, wrist, or hand.

5. When to use CPT code 73221

CPT code 73221 should be used when a healthcare provider performs an MRI of any joint in the upper extremity without the administration of contrast material. It is important to note that this code is specific to MRI scans without contrast and should not be used when contrast material is utilized during the procedure.

6. Documentation requirements

To support a claim for CPT 73221, the healthcare provider must document the following information:

• The specific joint of the upper extremity that was scanned
• Confirmation that the MRI was performed without the use of contrast material
• Date of the procedure
• Any relevant findings or abnormalities observed during the scan
• Interpretation and analysis of the images by the healthcare provider
• A written report summarizing the results of the MRI

7. Billing guidelines

When billing for CPT 73221, ensure that the MRI scan was performed without the use of contrast material. It is important to append the appropriate modifiers, such as modifier 26 for the professional component or modifier TC for the technical component, based on the specific circumstances and payer guidelines. Additionally, be aware of any specific payer policies regarding the reporting of contrast material separately.

8. Historical information

CPT 73221 was added to the Current Procedural Terminology system on January 1, 1990, as a code for MRI imaging of any joint in the upper extremity without contrast material. There have been no updates or changes to the code since its addition.

9. Examples

1. A patient undergoes an MRI scan of their shoulder joint without the use of contrast material to assess a suspected rotator cuff tear.
2. A healthcare provider performs an MRI of a patient’s wrist joint without contrast material to evaluate the presence of carpal tunnel syndrome.
3. An individual undergoes an MRI scan of their elbow joint without the administration of contrast material to assess potential ligament damage.
4. A patient receives an MRI of their hand joints without the use of contrast material to investigate the presence of arthritis.
5. A healthcare provider performs an MRI scan of a patient’s shoulder joint without contrast material to evaluate a suspected labral tear.
6. An individual undergoes an MRI of their wrist joint without the administration of contrast material to assess the extent of a ganglion cyst.
7. A patient receives an MRI scan of their elbow joint without the use of contrast material to investigate the presence of bursitis.
8. A healthcare provider performs an MRI of a patient’s hand joints without contrast material to evaluate the presence of trigger finger.
9. An individual undergoes an MRI scan of their shoulder joint without the administration of contrast material to assess potential tendonitis.
10. A patient receives an MRI of their wrist joint without the use of contrast material to investigate the presence of a ligament sprain.