How To Use CPT Code 74183

CPT 74183 refers to an MRI of the abdomen performed both without and with contrast material, and this article will cover its description, procedure, qualifying circumstances, usage, documentation requirements, billing guidelines, historical information, similar codes, and examples.

1. What is CPT 74183?

CPT 74183 is a medical billing code used for magnetic resonance imaging (MRI) of the abdomen, performed initially without contrast material and then with contrast material and further sequences. This diagnostic imaging study helps physicians diagnose and treat various medical conditions by providing detailed images of the abdominal organs and structures.

2. 74183 CPT code description

The official description of CPT code 74183 is: “Magnetic resonance (eg, proton) imaging, abdomen; without contrast material(s), followed by with contrast material(s) and further sequences.”

3. Procedure

1. The patient is instructed not to eat or drink for a few hours before the test.
2. The patient is positioned supine on the MRI table, which slides into a large tunnel-shaped magnetic scanner.
3. Images of the abdomen are taken without contrast material.
4. Contrast material is injected through a small catheter placed in the vein of the arm or hand.
5. Additional images are taken with the contrast material and further sequences.
6. The technician captures the radiofrequency signals generated by the body.
7. A computer generates a series of images displaying slices of the target area.
8. The physician reviews both non-contrast and contrast images and forms a diagnostic impression, which is written into a report.

4. Qualifying circumstances

Patients eligible to receive CPT code 74183 services are those who require a detailed examination of their abdominal organs and structures for the diagnosis and treatment of various medical conditions. These conditions may include, but are not limited to, tumors, infections, inflammation, and other abnormalities within the abdomen. The physician must determine that an MRI with both non-contrast and contrast-enhanced images is medically necessary for the patient’s specific situation.

5. When to use CPT code 74183

It is appropriate to bill the 74183 CPT code when a physician orders an MRI of the abdomen to be performed both without and with contrast material, and further sequences are required for a comprehensive evaluation of the patient’s abdominal organs and structures. This code should be used when the physician determines that the combination of non-contrast and contrast-enhanced images is necessary for accurate diagnosis and treatment planning.

6. Documentation requirements

To support a claim for CPT 74183, the following information must be documented:

• Medical necessity for the MRI of the abdomen with both non-contrast and contrast-enhanced images.
• Specific clinical indications for the procedure, such as suspected tumors, infections, or other abnormalities.
• Details of the procedure, including the administration of contrast material and the acquisition of further sequences.
• Findings and diagnostic impressions from the physician’s review of the images.
• Any recommendations for further evaluation or treatment based on the MRI findings.

7. Billing guidelines

When billing for CPT code 74183, keep in mind the following guidelines and rules:

• Append professional component modifier 26 to the radiology code if reporting only the physician’s interpretation for the radiology service.
• Append modifier TC to the radiology code if reporting only the technical component for the radiology service. Note that payer policy may exempt hospitals from appending modifier TC because the hospital’s portion is inherently technical.
• Do not append a professional or technical modifier to the radiology code when reporting a global service in which one provider renders both the professional and technical components.

8. Historical information

CPT 74183 was added to the Current Procedural Terminology system on January 1, 2001. There have been no updates to the code since its addition.

9. Similar codes to CPT 74183

Five similar codes to CPT 74183 and how they differentiate are:

• CPT 74181: MRI of the abdomen without contrast material.
• CPT 74182: MRI of the abdomen with contrast material.
• CPT 74176: Computed tomography (CT) of the abdomen without contrast material.
• CPT 74177: CT of the abdomen with contrast material.
• CPT 74178: CT of the abdomen without contrast material, followed by with contrast material and further sequences.

10. Examples

Here are 10 detailed examples of CPT code 74183 procedures:

1. A patient with a suspected abdominal mass requiring further evaluation with both non-contrast and contrast-enhanced MRI images.
2. An individual with a history of liver disease needing a comprehensive assessment of liver parenchyma and vasculature using MRI with and without contrast material.
3. A patient with unexplained abdominal pain and inconclusive findings on previous imaging studies, requiring an MRI of the abdomen with both non-contrast and contrast-enhanced images for further evaluation.
4. An individual with a known pancreatic lesion requiring an MRI of the abdomen with and without contrast material to assess the extent of the lesion and plan for potential surgical intervention.
5. A patient with suspected Crohn’s disease needing an MRI of the abdomen with both non-contrast and contrast-enhanced images to evaluate the extent of bowel involvement and complications.
6. An individual with a history of renal cell carcinoma requiring an MRI of the abdomen with and without contrast material for surveillance and detection of potential recurrence.
7. A patient with a suspected abscess in the abdominal cavity requiring an MRI of the abdomen with both non-contrast and contrast-enhanced images for accurate localization and treatment planning.
8. An individual with a history of abdominal aortic aneurysm needing an MRI of the abdomen with and without contrast material to assess the size and stability of the aneurysm.
9. A patient with unexplained weight loss and suspected malignancy requiring an MRI of the abdomen with both non-contrast and contrast-enhanced images for comprehensive evaluation of the abdominal organs and structures.
10. An individual with a history of pelvic inflammatory disease and suspected complications involving the abdominal organs, requiring an MRI of the abdomen with and without contrast material for further assessment.