Radiology Coding Alert

Question: Has coding for magnetic resonance arthrography of the shoulder changed since last year? We have been using 23350 (injection procedure for shoulder arthrography) and 73221 (magnetic resonance [e.g., proton] imaging, any joint of upper extremity). Plus, weve been billing 76000 for fluoroscopic guidance. Are these correct?
Maine Subscriber   Answer: The fluoroscopy and MRI codes have changed from those you have been reporting. As of Jan. 1, 2001, your practice should be assigning the following codes in addition to 23350 (which has stayed the same and should still be coded and billed to report the injection service):
73222 -- magnetic resonance (e.g., proton) imaging, any joint of upper extremity; with contrast material[s]
76003 -- fluoroscopic guidance for needle placement (e.g., biopsy, aspiration, injection, localization device)   Some coding experts note that practices may also report A4647 (supply of paramagnetic contrast material [e.g., gadolinium]) for the contrast materials. However, others say paramagnetics are bundled into the service and may not be reported separately. One exception may occur on those rare occasions when a double dose of contrast is used during an MRI of the brain. Coders should check with individual payers for their policies regarding contrast materials.