(2023) CPT Code 73721 | Description, Guidelines, Reimbursement, Modifiers & Examples

CPT code 73721 can be used for Diagnostic Radiology (Diagnostic Imaging) Procedures of the Lower Extremities, according to the American Medical Association (AMA). CPT 73721 is a medical procedure code for a lower extremity joint.

The CTP code 73721 can utilize contrast-free magnetic resonance imaging (MRI) as part of this diagnostic technique.

While CT(Computed Tomography) can scan in multiple planes and is affected by bone artifacts, MRI has better contrast, can image multiple planes, can visualize the vascular system, and uses less dangerous contrast agents than CT.

If conventional radiography is insufficient, an MRI can be required. It can improve diagnostic sensitivity and speed up the early detection of several articular diseases. However, insurance does not cover contraindications and applications.

Suppose specific precautions must be taken to ensure that the MRI environment does not negatively impact the interpretation of the MRI results or the proper functioning of the implanted device.

Some measures (described in greater detail below) could enhance the benefits of MRI exposure for participants in clinical trials evaluating the efficacy and safety of MRI exposure. 

Patients with viable pregnancies, devices containing ferromagnetic material, and claustrophobic patients are among those who can be affected and symptoms not covered by Medicare.

According to CMS, MRI of cortical bone and calcifications is not covered because it does not meet the criteria for reasonable and necessary.

Recurring preventive maintenance of the MRI site’s equipment should involve quality control testing, which can be documented in the facility’s service records. In addition, as previously stated, proper documentation of physician peer-review activities can incorporate employee competency criteria.

Description Of The 73721 CPT Code

The official description of CPT code 73721 is: “Magnetic resonance (e.g., proton) imaging, any joint of lower extremity; without contrast material.”

The most typical recommendation for this code is an MRI of the leg joint; any abnormalities in the soft tissues can be found using MRI. In radiology and interventional radiology, MRI codes can frequently employ the employee.

The appropriate imaging modality can be chosen on a personal level. In certain circumstances, X-rays are the most excellent option for the initial evaluation; in others, an MRI can be the ideal first step.

An MRI of the affected joint can be recommended when one of the following illnesses is present:

• She is suspected when standard X-rays are insufficient to provide the necessary information. 
• Joint MRIs are appropriate for disorders such as tumors, masses, or edema that affect or are near joints in patients.
• Shoulder pain caused by impingement or tears in the rotator cuff.
• Degenerative alterations within joint cartilage, including osteochondral degeneration.
• A near-joint tumor or nerve compression is suspected.
• Ligaments or tendons can harm.
• Kienbock’s disease of the wrists.
• Soft tissue anomalies can be associated with joint bone abnormalities.
• A variety of non-joint illnesses can impact joints and their supporting components.
• Pain or sensory abnormalities in joints or surrounding structures are possible.
• Lack of strength or other motor issues in joints or other body parts.
• Movement limits; stiffness; popping and clicking; instability or discoordination of joints or other structures.
• An anomaly discovered via another examination in the joints or other structures.
• Ligament or meniscal tears.

Before performing an interventional procedure, it is vital to assess joints and the structures that support them.

MRI without contrast material/materials, MRI with contrast material/materials, and MRI without contrast material/materials followed by contrast material/materials can all be reported using the CPT code 73721, 73722, or 73723.

MRI is used to detect any soft tissue abnormalities. For MRI without contrast of the knee, ankle, midfoot, wrist, and hip, utilize the 73721 CPT code.

With this CPT code, the lower extremity joint can invoice. Add the RT modifier after the CPT code. For example, right shoulder MRIs with distinction can report using CPT 73722, and those without contrast materials can use CPT 73723.

Billing Guidelines

The CPT code for diagnostic radiology and radiology is 73721. The most prevalent diagnosis for this code is a leg joint MRI scan.

If no contrast materials are utilized, followed by contrast material, CPT 73723 can be recorded (s). Heart pacemakers, ferromagnetic clips, and cochlear implants are a few examples.

For an MRI without contrast of the right shoulder, use the 73721 CPT code. MRI codes can be used in radiology and interventional radiology. However, there are some relative contraindications to MRI scanning.

When routine X-rays are unclear, and the patient has had therapy failure for a clinically discovered problem through medical history and examination, an MRI of the affected joint can commonly be performed. 

The results of a joint MRI are generally not suggested unless the MRI data will aid in identifying the best surgical approach. For example, it is confirmed whether an arthroscopic or open surgical assessment for a joint can be planned.

MRI tests are only covered if the underlying medical condition can be revealed in these cases. When reporting bilateral procedures, some commercial insurance or payors can need RT and LT modifiers instead of a modifier. 

A knee X-ray, for example, is taken by the doctor on both the right and left knees. Therefore, instead of billing as a single line with modifier 50, 73562, it is possible to bill as two lines, such as 73562-RT and 73562-LT. 

Suppose the code descriptor for the process or service does not include the terms bilateral or unilateral. In that case, it can execute in the same session and encounter the other processes and services. In this case, it adds 50 to the CPT codes and can be reimbursed. 

Modifiers

The codes 73721 (structural) and 73721-XS (structural) will show structural differences between an MRI ankle and an MRI knee.

When reporting bilateral procedures, some commercial insurance or payors can need RT and LT modifiers instead of a modifier. 

Imaging for screening or duplicate imaging can not be deemed medically necessary. For example, the doctor will take an X-ray of each patient’s right and left knees.

It means that instead of one line with modifier 50, 73562-50, it can be billed as two lines, 73562-RT and 73562-LT.

Reimbursement

By the physician fee schedules’ permitted rates for commercial and Medicare insurance, adding modifier 50 to the therapy or procedure can increase compensation by up to 150 percent.

Tumors less than 0.5 centimeters in diameter will commonly be removed from Medicare patients, for example.

The bilateral indicator one means that 50 should be billed to the client, as represented by the MPFS Relative Value. CTP Code 73721 can be used to report service and has a $200 maximum. Modifier 50 might raise the total to $300.

Billing example

A 32-year-old lady arrives at work with pain in both hands. She had activated his finger by accident four days earlier. It didn’t help, so she tried taking painkillers.

The doctor administered a trigger injection as a means of relieving pain. Any worries concerning the patient’s urine, headache, shortness of breath, back discomfort, abdominal pain, nausea, vomiting, or diarrhea can be disputed by the patient.

In this case, CPT 73721 can be billed.