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CPT Codes For MRI Knee | CPT 73221, CPT 73222, CPT 73223 & CPT 70336 | Billing Guide

CPT 73221, CPT 73222, CPT 73223, and CPT 70336 are procedural CPT codes for MRI knee (Magnetic resonance imaging to treat knee discomfort). Below are the descriptions and billing guidelines for the MRI knee CPT codes.

There are several advantages to using CPT codes for MRI knee instead of CT codes, like higher tissue contrast, multiplanar imaging, the capacity to monitor blood arteries, and safer contrast agents.

If standard radiography results are inconclusive, a diagnostic CPT code MRI for the knee would require. It should be improved by diagnostic sensitivity and assist in earlier diagnosing a subset of knee disorders.

TIP: You can find all the MRI CPT codes here.

Under some situations, any joint in the lower extremities (CPT 73721, CPT 73722, and CPT 73723) can be considered medically necessary and are acceptable CPT codes for an MRI knee procedure. Other disorders are avascular necrosis, osteomyelitis, and intraarticular derangement.

As part of a diagnostic MRI knee procedure, magnetic resonance imaging without contrast can be used with the CTP code 73721. If standard radiography is insufficient, an MRI for the knee is required.

An MRI knee CPT code procedure can be improve diagnostic sensitivity and speed the early diagnosis of a few knee-related diseases. However, insurance can not be covered applications or certain medications.

A few measures can boost the benefits of MRI CPT code exposure for participants in clinical trials by assessing its effectiveness in knee medical procedures.

An MRI knee CPT code procedure can affect patients with viable pregnancies, those who use ferromagnetic equipment, and those who are claustrophobic. Unfortunately, Medicare does not cover these symptoms. 

According to CMS, an MRI of cortical bone in the knee and calcifications should not be reimbursed since it does not meet the definition of a reasonable and necessary expense for an MRI knee CPT code.

The radiology and diagnostic radiology CPT code are 73562. The standard guideline for this code is to use it for a three-view knee x-ray. In addition, use CPT code 73565 for a standing view of both knees while assessing morphology (form and structure). 

Generally, patients with osteoarthritis receive this evaluation as part of preoperative preparation. This code should be reported in the case of the anterior knee disorder, and only the standing perspective will consider. This code should not utilize for two-person studies or three knee views, even if one is a fixed view.

CPT code 27369 can be added to account for traditional arthrography (knee Replacement) and CT/MRI studies. This code should not be reported for arthrocentesis or any other type of injection; it is just for contrast injections.

If fluoroscopy guides the injection, then CPT code 77002 can be used. According to CPT requirements, the CPT 77002 (Fluoroscopic guidance) should be appended to this code, along with the appropriate “with contrast” CT or MRI code.

Remember that Medicare patients can now get an NCCI adjustment that combines fluoroscopy with CT and MRI codes.

If you bill an old-fashioned knee arthroscopy, you can submit operation CPT 73580 and CPT 27369. Studying the first-quarter 2019 NCCI modifications for these code sets is critical.

Descriptions Of The CPT Codes For MRI Knee

A hospital specializing in radiology and interventional radiology can regularly utilize MRI codes. Knee soft tissue disorders are diagnosed with an MRI (Magnetic Resonance Imaging).

The primary objective of an MRI of the knee can be used to detect a tear in the joint. The following CPT codes apply to the knee, ankle, midfoot, wrist, and hip diagnosis and treatments.

CPT 73221: The 73221 CPT code can be used as a CPT code for MRI knee and is officially described in CPT’s manual: “Magnetic resonance (eg, proton) imaging, any joint of the lower extremity; without contrast material.”

TIP: We have written an article about CPT code 73721. You can find the billing guidelines for CPT 73721 here.

CPT 73722: The 73222 CPT code can be used as a CPT code for MRI knee and is officially described in CPT’s manual: “Magnetic resonance (eg, proton) imaging, any joint of the lower extremity; with contrast material(s).”

CPT 73723: The 73223 CPT code can be used as a CPT code for MRI knee and is officially described in CPT’s manual: “Magnetic resonance (eg, proton) imaging, any joint of the lower extremity; without contrast material(s), followed by contrast material(s) and further sequences.”

CPT 70336: The 70336 CPT code can be used as a CPT code for MRI knee and is officially described in CPT’s manual: “Magnetic resonance (eg, proton) imaging, temporomandibular joint(s).”

TIP: You can find the billing guide for all the MRI CPT codes here.

CPT 73721, CPT 73222, and CPT 73723 can be defined to use for magnetic resonance imaging (MRI) with or without contrast material(s) and MRI without contrast material(s) followed by contrast material (s).

Use CPT code 73722 when recording a contrast-enhanced MRI of the knee, ankle, midfoot, wrist, or hip. This CPT code can be used for billing purposes involving any lower extremity joint. MRI Examination of any knee, ankle, or foot (for instance, proton imaging). 

Add the RT modifier to the CPT code if the procedure requires no contrasting material followed by sequences with contrast material. To report an MRI of the right knee without contrast, use code 73721 in the CPT section. 

Billing Guidelines For The MRI Knee CPT Codes

The particular modifiers can be utilized for billing for CTP code 73721, which can benefit the patient and the treating physician. Use CPT code 73721 when ordering an MRI of the left shoulder without contrast.

CPT code 73722 can be used to report a left shoulder MRI with distinction. In the absence of contrast materials, the recording of CPT 73723 can be involved the use of contrast materials. An MRI of a leg joint is the most common type of diagnostic testing for this diagnosis.

Ferromagnetic clips, cochlear implants, and heart pacemakers are examples of this. Diagnostic radiology and radiology procedures can both be assigned the CPT code 73721.

Some commercial insurance firms or payors should be requested for the RT and LT modifiers in place of a modifier when reporting bilateral operations.

For illustration, the doctor should take X-rays of the patient’s right and left knees. Consider the possibility that the terms bilateral and unilateral should not be included in the process or service’s code definition.

In that situation, it should be able to cohabit with other techniques and services running in the same session. In this case, it is feasible to repay by adding modifier 50 to the MRI knee CPT codes.

How To Use Modifiers For The CPT Codes For MRI Knee

Below we describe the most commonly used modifiers for the CPT code of MRI Knee procedures: modifier 50, Modifier 76, Modifier RT, and Modifier LT.

CPT 73721, CPT 73722, and CPT 73723, respectively, describe knee MRI without contrast material/materials, MRI with contrast material/materials, and knee MRI without contrast material/materials followed by contrast material/materials.

When submitting CPT code 73721 twice, modifier 76 should be reported. Consider a patient who requires both a knee and hip MRI but has only one available appointment slot.

The best practice for a left knee MRI without contrast can be used for CPT code 73721. The CPT code 73722 is the correct one for an MRI of the left shoulder that reveals a distinction. The medical record should either explicitly mention or infer the clinical necessity for a joint MRI.

Modifier 50 should be utilized if an MRI service covers both knees. Rather than utilizing modifier 50, several insurance firms can be used modifiers RT and LT. If the exam performs on the same body side but with a different joint or non-joint, the 2015-introduced XS modifier could be a substitute.

Using the structural codes CPT 73721 or CPT 73721-XS, an MRI of the ankle or knee will identify anatomical discrepancies between the two joints.

Some commercial insurance firms or payors should be required to use modifiers RT and LT when reporting bilateral operations.

Screening and unnecessary imaging cannot be evaluated based on medical necessity. The physician should examine the patient’s right and left knees for X-ray purposes.

Medicare Reimbursement

Modifier 50, in combination with the CPT codes for Knee MRI, can be used as the source to increase the payment by up to 150% based on the approved commercial and Medicare reimbursement rates.

Tumors smaller than 0.5 centimeters should usually be taken from people with Medicare. Because the MPFS Relative Value, shown by the bilateral indicator 1, says so, the client should be charged $50.

With CTP Code 73721, you can be reported the knee MRI CPT code service with a maximum payment of $200. If modifier 50 can be used, the amount could go up to $300.

Example

The 32-year-old woman feels discomfort in her knee during her working hours. She sought to alleviate the pain with medication, but it had little effect.

The physician can be administered a trigger drug to relieve the patient’s pain. The patient should be reported to express concerns regarding urination, headache, shortness of breath, back pain, abdominal pain, nausea, vomiting, or diarrhea.

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