Neurosurgery Coding Alert

Reader Questions:

Parse Spinal Canal MRIs by Anatomy

Question: Encounter notes indicate that the provider performed the following: “MRI cerv. spinal canal w/contrast …MRI thor. Spinal canal no contrast.” Should I report 72141 x 2 for this service?

AAPC Forum Subscriber

Answer: No, you should not follow that reporting path.

MRI primer: The code set for spinal canal MRIs is deeper than you might expect. It has codes broken down by spinal area, then further broken down to indicate the use (or non-use) of contrast material. Here’s a look how the code set breaks down:

  • 72141 (Magnetic resonance (eg, proton) imaging, spinal canal and contents, cervical; without contrast material)
  • 72142 (… with contrast material(s))
  • 72147 (… with contrast material(s))
  • 72148 (Magnetic resonance (eg, proton) imaging, spinal canal and contents, lumbar; without contrast material)
  • 72149 (… with contrast material(s))
  • 72156 (Magnetic resonance (eg, proton) imaging, spinal canal and contents, without contrast material, followed by contrast material(s) and further sequences; cervical)
  • 72157 (… thoracic)
  • 72158 (… lumbar)

Coding: On your claim, report:

  • 72142 for the cervical spinal canal MRI.
  • 72146 for the thoracic spinal canal MRI.

Best bet: Check your spinal canal notes against these code descriptors, and you should be able to arrive at the most accurate spinal canal MRI code each time.