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2025 CPT code 73220

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

Refer to the AMA CPT manual for the most current guidelines.Appropriate use of modifiers 26 (professional component only) or TC (technical component only) may be required depending on the payer and setting.

Modifiers 26 (professional component) and TC (technical component) are applicable.Modifier 59 (distinct procedural service) may be necessary if multiple distinct MRI sequences are performed on different areas of the upper extremity.Other modifiers may apply depending on the circumstances.

Medical necessity is established based on the patient's symptoms, clinical findings, and the need to visualize specific anatomical structures in the upper extremity to guide appropriate diagnosis and treatment planning.

The clinical responsibility includes patient preparation, administering contrast (if applicable), acquiring MRI images, image analysis, and generating a comprehensive report detailing findings and interpretation.

IMPORTANT:73218 (MRI, upper extremity, excluding joints, without contrast), 73219 (MRI, upper extremity, excluding joints, with contrast), 73221 (MRI, any joint of upper extremity, without contrast), 73222 (MRI, any joint of upper extremity, with contrast), 73223 (MRI, any joint of upper extremity, without and with contrast).

In simple words: This medical test uses a powerful magnet and radio waves to create detailed pictures of your arm and hand (but not the joints like your elbow or wrist). The test is done twice: once without, and once with, a special dye injected to improve the images. A doctor will review the pictures and give you the results.

This CPT code encompasses a magnetic resonance imaging (MRI) procedure of the upper extremity, excluding joints. The procedure involves two phases: first, an MRI is performed without contrast material; subsequently, contrast material is administered intravenously, followed by another MRI sequence.The physician interprets the images from both sequences to produce a comprehensive report of findings.

Example 1: A patient presents with unexplained upper arm pain.The physician orders an MRI of the upper arm (excluding the shoulder joint) with and without contrast to rule out soft tissue injuries, tumors, or infections., A patient has a history of a previous fracture of the humerus.An MRI with and without contrast of the affected area is ordered to assess healing, potential complications, or nonunion., A patient experiences numbness and tingling in their forearm following a motor vehicle accident. An MRI with and without contrast is ordered to evaluate for nerve compression or damage.

Detailed clinical history, reason for the MRI, images acquired, contrast administration details (if applicable), and the final radiology report with the physician's interpretation.

** Payers may have specific requirements regarding contrast coverage.Always refer to the payer's specific policies for accurate billing and reimbursement.

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