Wiki MRI-Mod LT/RT

[mmunoz21]

Hello,

CPT 72195 (MRI of Pelvis), I have a claim from a provider with 72195-LT, 72195-RT (right and left hip), wouldn't MRI of Pelvis include both LT/RT or is the way it billed correct?

 

[dpeoples]

Hello,

CPT 72195 (MRI of Pelvis), I have a claim from a provider with 72195-LT, 72195-RT (right and left hip), wouldn't MRI of Pelvis include both LT/RT or is the way it billed correct?

I do not think it is billed correctly. There are not two pelvises (LT/RT) so the modifier does not apply. It should be billed only once.

Perhaps they should have coded for extremities instead but that depends on the documentation.

I hope this helps.

 

[vikas.maheshwari]

Use 73721-LT and 73721-RT for Hip MRI if the procedure performed without contrast for with contrast use 73722 and for with and without contrast use 73723.


Thanks,

Vikas Maheshwari

MBA-HCS, CPC-H

 

[jgf-CPC]

Hi!

This is what we use to tell the difference:
When you need to code for bilateral hip MRIs, don't be tempted to report an MRI of the pelvis (72195-72197, Magnetic resonance [e.g., proton] imaging, pelvis ...). The CPT codes for a pelvis MRI are not joint codes. When the order is for a hip MRI, only use the lower- extremity joint codes 73721-73723.

Only use the MRI pelvis codes if the order is specifically for a pelvis MRI and/or the physician looks at the pelvic viscera, such as the organs and soft tissue.

Hope it helps!!