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2025 CPT code 73218

Magnetic resonance imaging (MRI) of the upper extremity (excluding joints), without contrast material.

Adhere to the most up-to-date CPT coding guidelines for radiology procedures and imaging.Pay close attention to anatomical location specifications to ensure appropriate code selection.Consult payer-specific guidelines regarding the use of modifiers and billing practices.

Modifiers 26 (professional component) and TC (technical component) may be appended depending on who performs each component of the service.Payer policies may vary.Modifier 59 (distinct procedural service) may apply in certain situations; consult NCCI edits.

The medical necessity for this code is determined by the clinical indication for the MRI.Appropriate indications include but are not limited to evaluation of unexplained pain, suspected soft tissue injuries, and assessment of nerve compression or other neurological conditions. The ordering physician must document the medical necessity in the patient's medical record.

The radiologist is responsible for performing the MRI scan, interpreting the images, and generating a report of findings.The referring physician is responsible for ordering the test and integrating the results into the patient's overall care.

IMPORTANT:For MRI of the upper extremity, excluding joints, with contrast, see 73219. For MRI of the upper extremity, excluding joints, without contrast followed by contrast and additional sequences, see 73220.For MRI of upper extremity joints, see codes 73221 (without contrast), 73222 (with contrast), and 73223 (without contrast followed by contrast and additional sequences).

In simple words: This test uses a large magnet and radio waves to create detailed pictures of your arm (excluding the shoulder, elbow, and wrist). No special dye is used. The doctor will look at the images and give you a report explaining what they show.

This CPT code encompasses a non-invasive diagnostic procedure involving magnetic resonance imaging of the upper extremity, excluding joints such as the shoulder, elbow, and wrist. The procedure utilizes magnetic fields and radio waves to generate detailed images of the soft tissues, bones, muscles, tendons, ligaments, and other structures in the specified area.Contrast material is not administered during this examination. The radiologist interprets the resulting images and prepares a comprehensive report detailing findings.

Example 1: A patient presents with unexplained forearm pain.An MRI of the forearm (73218) is ordered to rule out soft tissue injuries, fractures, or other underlying causes., A patient sustains a non-joint-related injury to the upper arm in an accident. An MRI (73218) is performed to assess the extent of muscle and soft tissue damage., A patient reports persistent numbness in the hand. A non-contrast enhanced MRI (73218) of the hand (excluding the wrist) is conducted to evaluate for nerve compression or other neurological issues.

* Physician's order specifying the clinical indication for the MRI.* Complete patient history and physical examination notes relevant to the upper extremity.* Radiologist's report interpreting the MRI images, including detailed descriptions of findings.* Images from the MRI scan.

** Always verify payer-specific guidelines for coverage criteria, coding conventions, and reimbursement policies before billing.

** Only Enterprise users with EHR integration can access case-specific answers. Click here to request access.

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