2025 CPT code 72197
Magnetic resonance (eg, proton) imaging, pelvis; without contrast material(s), followed by contrast material(s) and further sequences.
Modifiers 26 (Professional Component) and TC (Technical Component) may be applicable. Modifier 26 is used when reporting only the physician's interpretation of the MRI, while TC is used when reporting only the technical component of the service.Check payer guidelines before using modifier TC, as some payers exempt hospitals from appending it. Do not use either modifier when reporting a global service where one provider performs both the professional and technical components.
Medical necessity for this procedure must be supported by documentation that justifies the need for the MRI. The documentation should demonstrate that the information obtained from the MRI is necessary for the diagnosis, management, or treatment of the patient's condition.
In simple words: An MRI of your pelvis will be performed. The first set of images will be taken without any dye. Then, a special dye will be injected into your vein, and more images will be taken to get a clearer picture.An MRI uses magnets and radio waves to create detailed pictures of the inside of your body.
This diagnostic procedure involves magnetic resonance imaging (MRI) of the pelvis. Initially, images are acquired without contrast material. Subsequently, a contrast agent is administered intravenously, and further sequences of images are obtained to enhance the visualization of anatomical structures. The patient is positioned within the MRI scanner, and radiofrequency signals generated by the body within the magnetic field are captured. These signals are then processed by a computer to create a series of cross-sectional images of the pelvis.
Example 1: A patient presents with chronic pelvic pain. An MRI of the pelvis with and without contrast is ordered to evaluate for any underlying pathology, such as endometriosis, tumors, or inflammation., A patient with a history of prostate cancer undergoes an MRI of the pelvis with and without contrast to assess for local recurrence or metastasis., Following a traumatic pelvic injury, a patient receives an MRI with and without contrast to evaluate the extent of soft tissue damage, fractures, and vascular compromise.
Documentation should include the reason for the MRI, the patient's relevant medical history, the interpretation of the images, and any significant findings. If contrast is used, the type and dose should be documented, as well as any adverse reactions.
- Modifier TC rule: Yes
- Specialties:Radiology
- Place of Service:Inpatient Hospital, On Campus-Outpatient Hospital, Off Campus-Outpatient Hospital, Independent Clinic, Ambulatory Surgical Center, Mobile Unit