CPT Code 73721, cpt 73721, 73721 cpt code, 73721

CPT Code 73721 | Description, Guidelines, Reimbursement, Modifiers & Examples

CPT code 73721 can use for Diagnostic Radiology (Diagnostic Imaging) Procedures of the Lower Extremities, according to 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. You can find the CPT codes and billing guidelines for MRI here.

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, MRI can be required. It can improve diagnostic sensitivity and speed up the early detection of a small number of articular diseases. However, insurance does not cover contraindications and applications.

On or after July 7, 2011, or on or after February 24, 2011, the contraindications no longer apply when pacemakers can use in an MRI environment by FDA-approved labeling. Although the data is not yet conclusive, CMS believes that MRI will improve patient health outcomes.

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

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 document in the facility’s service records. In addition, as previously stated, proper documentation of physician peer-review activities can incorporate employee competency criteria.

73721 CPT Code Description

The CPT code for radiology and diagnostic imaging is 73721. The CPT manual describes this code: “Magnetic resonance (eg, proton) imaging, any joint of the lower extremity; without contrast material.”

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

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

An MRI of the affected joint can recommend when one of the following illnesses is present or :

  • 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 associate 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.
  • recognizing 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 report 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, and 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 billing for CTP code 73721 follows some specific modifiers that will benefit both physician and patient.

For MRI without contrast of the left shoulder, use the 73721 CPT code. For reporting a left shoulder MRI with distinction, use CPT 73722.

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

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

For MRI without contrast of the right shoulder, use the 73721 CPT code. MRI codes can use 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 perform. 

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 true whether an arthroscopic or open surgical assessment for a joint can plan.

MRI tests are only covered if the underlying medical condition can reveal 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 as the other processes and services. In this case, it adds 50 to the CPT codes and can reimburse. 

Modifiers

The modifiers used for CPT code 73721 are 50, LT, RT, and 59.

If a procedure is repeated on the same day by the same clinician, modifier 59 or modifier 77 can be used to report an MRI shoulder.

If you are only checking your right shoulder, use the modifier RT. For an MRI of the right shoulder, use the RT modifier. If an MRI service will provide for both shoulders, add modifier 50. In place of modifier 50, specific payers demand modifiers RT and LT individually.

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

Using the 73721 CPT code is a better option for MRI without contrast of the left shoulder. For writing a left shoulder MRI with distinction, use CPT 73722.

A joint MRI is clinically necessary only if it is specifically indicated in the medical record or can infer from it.

If an MRI service can provide for both shoulders, add modifier 50. In place of modifier 50, specific payers demand modifiers RT and LT individually.

If the exam can perform on the same side of the body, but with a different joint or non-joint, the XS modifier (a new modifier published in 2015) can use as an option. 

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 deem 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 bill as two lines, 73562-RT and 73562-LT.

The American Medical Association decide in their most recent CPT update that the 50 modifiers will not use for add-on codes.

Any code added to a primary, to put it another way. An excellent example is injecting the facet joints at the second and third levels.

Under the new standards, the first level will have a 50 (bilateral) modifier, and each group after that will invoice as two line items, one for the right (RT) and one for the left (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 remove 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.

Example

A 32-year-old lady arrives at work with pain in both hands. She 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 dispute by the patient.

In this case, CPT 73721 can be billed.

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