2025 CPT code 73223
(Active) Effective Date: N/A Revision Date: N/A Radiology - Magnetic Resonance Imaging (MRI) Diagnostic Radiology (Diagnostic Imaging) Procedures of the Upper Extremities Feed
MRI of any upper extremity joint; without contrast, followed by contrast and further sequences.
Modifiers 26 (professional component), TC (technical component), and others (59, 76, 77) may be applicable depending on the specific circumstances of the service.
Medical necessity is established by demonstrating that the MRI is necessary to diagnose or manage a specific clinical condition affecting the upper extremity joint.This usually requires supporting documentation such as patient symptoms, physical exam findings, and potentially prior imaging studies.
The radiologist is responsible for performing the MRI scan, interpreting the images, and generating a report. The referring physician (e.g., orthopedist, rheumatologist) is responsible for ordering the test, making the diagnosis, and developing the treatment plan based on the radiologist's findings.
- Diagnostic Radiology (Diagnostic Imaging) Procedures of the Upper Extremities
- Diagnostic Radiology (Diagnostic Imaging) Procedures
In simple words: This code covers an MRI scan of a joint in your arm or hand.The scan is done twice: once without a special dye, and again after injecting the dye for clearer pictures.
This CPT code describes a magnetic resonance imaging (MRI) procedure of any joint in the upper extremity (shoulder, elbow, wrist, or hand joints). The procedure involves acquiring images without contrast material, followed by the administration of contrast material and acquisition of additional image sequences.The contrast used must be intravascular, intraarticular, or intrathecal. The physician interprets the images and prepares a report.
Example 1: An 8-year-old child falls and complains of elbow pain. X-rays are negative.An MRI with and without contrast (73223) is ordered to rule out ligamentous injury or other soft tissue damage., A patient presents with chronic shoulder pain and limited range of motion. An MRI with and without contrast (73223) is ordered to evaluate for rotator cuff tears, labral tears, or other underlying pathologies., A patient with rheumatoid arthritis experiences worsening wrist pain.An MRI with and without contrast (73223) is performed to assess the extent of joint inflammation and damage.
* Physician's order specifying the need for MRI of the specified upper extremity joint.* Detailed clinical history, including symptoms, mechanism of injury (if applicable), and past medical history.* Physical examination findings relevant to the affected joint.* Images from the MRI, including those before and after contrast administration.* Radiologist's report with detailed interpretation of findings and clinical correlation.
** The choice between codes 73222 and 73223 depends on whether the contrast was administered after the non-contrast images.Always document the contrast administration sequence correctly to ensure accurate coding.
- Revenue Code: I2D (ADVANCED IMAGING - MRI: OTHER)
- RVU: The relative value units (RVUs) for this code vary based on several factors, including geographic location, practice type (e.g., non-facility, facility), and payer.Consult the specific payer's fee schedule for the most accurate RVU information.
- Global Days: The global period for this procedure is typically not applicable, as it is a diagnostic imaging service.
- Payment Status: Active
- Modifier TC rule: Modifier TC may be appropriate if only the technical component of the MRI is billed.Hospital billing practices regarding modifier TC can vary.
- Fee Schedule: Historical fee schedules vary by payer and geographic location. Consult the appropriate payer's fee schedule for historical data.
- Specialties:Radiology, Orthopedics, Rheumatology, Sports Medicine
- Place of Service:Office, Outpatient Hospital, Ambulatory Surgical Center, Hospital (Inpatient or Outpatient)