Commonly Used MRI CPT Codes Explained: Brain, Spine, Abdomen & More

Accurate and proper diagnosis is the beginning of an effective medical treatment, and that begins with the proper imaging. Magnetic Resonance Imaging is one of the powerful instruments utilized in contemporary medicine to take precise images of the inside of the body. It is a harmless, pain-free, and very helpful method for detecting injuries, illness, or abnormalities in organs, soft tissues, and joints.

Radiologists and physicians use MRI scans daily to assess conditions of the brain, spine, joints, and numerous other areas. To ensure each category of MRI is well defined and properly billed, medical providers utilize distinct codes known as CPT codes. The codes facilitate precise documentation, effective healthcare team communication, and efficient insurance claims and reimbursements.

This blog will discuss the most frequently used MRI CPT codes for the various areas of the body.

Commonly Used MRI CPT Codes

To streamline medical billing and ensure accurate reimbursement, specific CPT codes are assigned to different types of MRI scans. The following are the commonly used MRI CPT codes across various body regions:

Brain and Neck MRI CPT Codes

MRI scans of the brain and neck are essential for diagnosing a wide range of neurological and structural disorders. These procedures can be performed with or without contrast, depending on clinical needs.

• 70551  MRI of the brain without contrast used for standard brain imaging.
• 70553  MRI of the brain with contrast for enhanced diagnostic clarity.
• 70544  MRI of the neck without contrast.
• 70547  MRI of the neck with and without contrast.
• 70549  MRI of the neck with contrast.
• 70540  MRI of the orbit (eye area) without contrast.
• 70543  MRI of the orbit with contrast.
• 70336  MRI of the TMJ (temporomandibular joint) used for assessing jaw disorders.

Spine MRI CPT Codes

MRI scans of the spine help detect issues such as herniated discs, spinal cord compression, infections, or degenerative diseases. The different codes used for each spinal section depend on the use of contrast.

• 72141  Lumbar spine MRI without contrast.
• 72146  Cervical spine MRI without contrast.
• 72148  Cervical spine MRI without contrast.
• 72156  Thoracic spine MRI without contrast.
• 72157  Thoracic spine MRI with contrast.
• 72158  Cervical spine MRI with contrast.

Breast MRI CPT Codes

MRI of the breast is particularly useful in evaluating abnormal mammogram results or screening high-risk individuals. These CPT codes ensure accurate documentation and billing for breast imaging.

• 77059  Bilateral breast MRI – comprehensive scan of both breasts.
• 77021  Unilateral breast MRI – targeted scan of one breast.

Joint MRI CPT Codes

MRI scans of joints are frequently ordered to diagnose injuries, arthritis, ligament tears, or infections. The use of contrast enhances image clarity for complex diagnoses.

• 73221  MRI of upper extremity joint (shoulder/elbow/wrist) without contrast.
• 73223  Upper extremity joint with contrast.
• 73721  MRI of lower extremity joint (hip/knee/ankle) without contrast.
• 73723  Lower extremity joint with contrast.
• 73131  Ankle MRI without contrast.
• 73133  Ankle MRI with contrast.

Extremities MRI CPT Codes

Extremity MRIs help diagnose muscle, tendon, joint, or bone abnormalities in arms and legs.

• 73718  MRI of both knees without contrast.
• 73720  MRI of thigh/lower extremity with contrast.
• 73218  MRI of the shoulder joint without contrast.
• 73220  MRI of the elbow joint with contrast.
• 73505  MRI of the foot without contrast.
• 73507  MRI of the foot with contrast.

Abdomen MRI CPT Codes

Abdominal MRIs are vital for diagnosing issues in the liver, pancreas, kidneys, spleen, and GI tract. The use of CPT codes helps categorize these procedures based on contrast use.

• 74181  MRI of the abdomen without contrast.
• 74183  MRI of the pelvis without contrast.
• 74185  MRI of lower extremity joints without contrast (often includes hips, knees, thighs).

Pelvis MRI CPT Codes

Pelvic MRIs provide detailed imaging of reproductive organs, bladder, and surrounding tissues. These are often used to assess conditions like fibroids, cysts, or pelvic inflammation.

• 72195  MRI of the pelvis without contrast.
• 72197  MRI of the pelvis with contrast.

Contrast vs. Non-Contrast MRI

One of the most critical differences when assigning MRI CPT codes is whether the scan was performed with contrast, without contrast, or both with and without contrast. This decides which CPT code should be used directly and is necessary for proper billing and reimbursement.

• Contrast MRI

A contrast MRI is a scan type whereby a special dye, typically gadolinium, is injected into your body via a vein before or during the scan. The dye allows the radiologist to distinguish between healthy and diseased tissues for the examination of the brain, spine, or organs. This dye helps highlight certain parts of the body more easily to facilitate the identification of conditions such as tumors, infections, swelling, or problems with blood vessels. A contrast MRI usually comprises taking two sets of images, i.e., one prior to the dye and the other after, in order to compare and obtain more precise findings.

• Non-Contrast MRI

A non-contrast MRI is a type of scan where no dye or injection is used. Approximately 85% of MRI scans are undertaken without contrast, as they provide physicians with a sufficient amount of information for a diagnosis. Even without contrast, it still produces detailed images of the inside of your body and is commonly used to screen for routine problems such as joint issues, backache, or large tumors. Such an MRI is also healthier for individuals with kidney issues or contrast dye allergies. It is also frequently used for brain, spine, joint, and soft tissue scans when additional enhancement is not required.

Conclusion

Accurate MRI CPT coding plays a key role in ensuring that medical procedures are properly documented and billed. Each CPT code is designed to reflect a specific type of MRI scan, whether it is for the brain, spine, joints, or any other part of the body. Using the correct codes not only helps providers meet compliance standards but also ensures that insurance claims are processed without delays or denials. This makes it easier for healthcare teams to focus on delivering quality patient care instead of dealing with billing complications.

It is also necessary to keep abreast of coding guidelines, CMS guidelines, and include the appropriate modifiers and ICD-10 codes that describe the condition of the patient. It not only helps in correct billing but also guarantees timely payment to the providers. Having trouble with MRI billing mistakes or claim denials for improper CPT coding? 24/7 Medical Billing Services excels at radiology billing with a clear emphasis on accurate MRI CPT codes to achieve clean claims and quick reimbursements. Our custom solutions guarantee your MRI procedures are billed and coded correctly the very first time. Contact us today for a free billing audit or consultation!

FAQs

Q1. Are MRI CPT codes the same for adults and children?

Only when documentation reflects age-specific clinical indications when required.

Q2. Do insurers require pre-authorization for MRI CPT codes?

Most insurers require prior authorization before covering MRI procedures.

Q3. How often do CPT codes for MRI get updated?

Codes are reviewed and updated annually by the AMA to reflect technology and policy changes.

Q4. Is there a CPT code for an MRI done under sedation?

Sedation is coded separately using anesthesia codes along with the MRI CPT code.

Q5. Are contrast agents billed separately from the MRI CPT code?

The contrast material is usually billed using HCPCS codes alongside the MRI code.