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Magnetic resonance imaging (MRI) of the pelvis, as described by CPT® Code 72196, is a sophisticated imaging technique that utilizes the magnetic properties of hydrogen nuclei within the body to create detailed images of the pelvic region and its internal structures. This noninvasive procedure does not involve ionizing radiation, making it a safer alternative for patients requiring diagnostic imaging. During the MRI, a powerful magnetic field is generated, which causes the hydrogen atoms in the body to align. Subsequently, radio waves are transmitted through this magnetic field, prompting the protons in various tissues to emit specific radiofrequency signals. These signals are captured by a computer, which processes the data to produce high-resolution tomographic images in three-dimensional slices. The patient undergoing this procedure is positioned on a motorized table that slides into a large MRI scanner, often referred to as a tunnel. To enhance the quality of the images, small coils may be strategically placed around the hip area to assist in the transmission and reception of radio waves. The use of contrast material, specifically iodine-based contrast dye, is a key aspect of CPT® Code 72196, as it is administered intravenously to improve the visibility of the target area, allowing for a more accurate assessment of potential abnormalities. This imaging modality is particularly valuable in diagnosing a range of conditions, including injuries, trauma, congenital anomalies, and unexplained pain in the hip or pelvic region. In males, pelvic MRI can be instrumental in evaluating testicular or scrotal swelling and locating undescended testicles, while in females, it is often employed to investigate issues such as abnormal vaginal bleeding, endometriosis, pelvic masses, or infertility concerns.
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Magnetic resonance imaging (MRI) of the pelvis with contrast material is indicated for various clinical scenarios where detailed visualization of pelvic structures is necessary. The following conditions and symptoms may warrant the use of this imaging technique:
The procedure for performing a magnetic resonance imaging (MRI) scan of the pelvis with contrast material involves several key steps to ensure accurate imaging and patient safety. The following outlines the procedural steps:
Following the MRI of the pelvis with contrast, patients are generally advised to drink plenty of fluids to aid in the elimination of the contrast material from their system. Most patients can resume normal activities immediately after the procedure, as there are typically no restrictions unless otherwise specified by the physician. It is important for patients to report any unusual symptoms or reactions, such as allergic reactions to the contrast dye, which may include rash, itching, or difficulty breathing. The images obtained during the MRI will be reviewed by a radiologist, who will provide a detailed report to the referring physician. This report will assist in diagnosing any identified conditions and determining the appropriate course of treatment based on the findings.
| Short Descr | MRI PELVIS W/DYE | Medium Descr | MRI PELVIS W/CONTRAST MATERIAL | Long Descr | Magnetic resonance (eg, proton) imaging, pelvis; with contrast material(s) | Status Code | Active Code | Global Days | XXX - Global Concept Does Not Apply | PC/TC Indicator (26, TC) | 1 - Diagnostic Tests for Radiology Services | Multiple Procedures (51) | 4 - Special payment adjustment rules on the technical component (TC) of multiple diagnostic imaging procedures apply... | Bilateral Surgery (50) | 0 - 150% payment adjustment for bilateral procedures does NOT apply. | Physician Supervisions | 09 - Concept does not apply. | Assistant Surgeon (80, 82) | 0 - Payment restriction for assistants at surgery applies to this procedure... | Co-Surgeons (62) | 0 - Co-surgeons not permitted for this procedure. | Team Surgery (66) | 0 - Team surgeons not permitted for this procedure. | Diagnostic Imaging Family | 88 - | APC Status Indicator | Codes That May Be Paid Through a Composite APC | ASC Payment Indicator | Radiology service paid separately when provided integral to a surgical procedure on ASC list; payment based on MPFS nonfacility PE RVUs. | Type of Service (TOS) | 4 - Diagnostic Radiology | Berenson-Eggers TOS (BETOS) | I2D - Advanced imaging - MRI/MRA: other | MUE | 1 | CCS Clinical Classification | 198 - Magnetic resonance imaging |
This is a primary code that can be used with these additional add-on codes.
| 0649T | Add-on Code MPFS Status: Carrier Priced APC S Quantitative magnetic resonance for analysis of tissue composition (eg, fat, iron, water content), including multiparametric data acquisition, data preparation and transmission, interpretation and report, obtained with diagnostic MRI examination of the same anatomy (eg, organ, gland, tissue, target structure); single organ (List separately in addition to code for primary procedure) | 0698T | Add-on Code Resequenced Code MPFS Status: Carrier Priced APC S ASC Z2 Quantitative magnetic resonance for analysis of tissue composition (eg, fat, iron, water content), including multiparametric data acquisition, data preparation and transmission, interpretation and report, obtained with diagnostic MRI examination of the same anatomy (eg, organ, gland, tissue, target structure); multiple organs (List separately in addition to code for primary procedure) |
| 26 | Professional component: certain procedures are a combination of a physician or other qualified health care professional component and a technical component. when the physician or other qualified health care professional component is reported separately, the service may be identified by adding modifier 26 to the usual procedure number. | 77 | Repeat procedure by another physician or other qualified health care professional: it may be necessary to indicate that a basic procedure or service was repeated by another physician or other qualified health care professional subsequent to the original procedure or service. this circumstance may be reported by adding modifier 77 to the repeated procedure or service. note: this modifier should not be appended to an e/m service. | GC | This service has been performed in part by a resident under the direction of a teaching physician | 51 | Multiple procedures: when multiple procedures, other than e/m services, physical medicine and rehabilitation services or provision of supplies (eg, vaccines), are performed at the same session by the same individual, the primary procedure or service may be reported as listed. the additional procedure(s) or service(s) may be identified by appending modifier 51 to the additional procedure or service code(s). note: this modifier should not be appended to designated "add-on" codes (see appendix d). | MG | The order for this service does not have applicable appropriate use criteria in the qualified clinical decision support mechanism consulted by the ordering professional | X5 | Diagnostic services requested by another clinician: for reporting services by a clinician who furnishes care to the patient only as requested by another clinician or subsequent and related services requested by another clinician; this modifier is reported for patient relationships that may not be adequately captured by the above alternative categories; reporting clinician service examples include but are not limited to, the radiologist's interpretation of an imaging study requested by another clinician | MH | Unknown if ordering professional consulted a clinical decision support mechanism for this service, related information was not provided to the furnishing professional or provider | TC | Technical component; under certain circumstances, a charge may be made for the technical component alone; under those circumstances the technical component charge is identified by adding modifier 'tc' to the usual procedure number; technical component charges are institutional charges and not billed separately by physicians; however, portable x-ray suppliers only bill for technical component and should utilize modifier tc; the charge data from portable x-ray suppliers will then be used to build customary and prevailing profiles | 52 | Reduced services: under certain circumstances a service or procedure is partially reduced or eliminated at the discretion of the physician or other qualified health care professional. under these circumstances the service provided can be identified by its usual procedure number and the addition of modifier 52, signifying that the service is reduced. this provides a means of reporting reduced services without disturbing the identification of the basic service. note: for hospital outpatient reporting of a previously scheduled procedure/service that is partially reduced or cancelled as a result of extenuating circumstances or those that threaten the well-being of the patient prior to or after administration of anesthesia, see modifiers 73 and 74 (see modifiers approved for asc hospital outpatient use). | 59 | Distinct procedural service: under certain circumstances, it may be necessary to indicate that a procedure or service was distinct or independent from other non-e/m services performed on the same day. modifier 59 is used to identify procedures/services, other than e/m services, that are not normally reported together, but are appropriate under the circumstances. documentation must support a different session, different procedure or surgery, different site or organ system, separate incision/excision, separate lesion, or separate injury (or area of injury in extensive injuries) not ordinarily encountered or performed on the same day by the same individual. however, when another already established modifier is appropriate it should be used rather than modifier 59. only if no more descriptive modifier is available, and the use of modifier 59 best explains the circumstances, should modifier 59 be used. note: modifier 59 should not be appended to an e/m service. to report a separate and distinct e/m service with a non-e/m service performed on the same date, see modifier 25. | AQ | Physician providing a service in an unlisted health professional shortage area (hpsa) | CR | Catastrophe/disaster related | GA | Waiver of liability statement issued as required by payer policy, individual case | LT | Left side (used to identify procedures performed on the left side of the body) | MB | Ordering professional is not required to consult a clinical decision support mechanism due to the significant hardship exception of insufficient internet access | ME | The order for this service adheres to appropriate use criteria in the clinical decision support mechanism consulted by the ordering professional | MF | The order for this service does not adhere to the appropriate use criteria in the clinical decision support mechanism consulted by the ordering professional | Q1 | Routine clinical service provided in a clinical research study that is in an approved clinical research study | Q6 | Service furnished under a fee-for-time compensation arrangement by a substitute physician or by a substitute physical therapist furnishing outpatient physical therapy services in a health professional shortage area, a medically underserved area, or a rural area | Ordering professional consulted a qualified clinical decision support mechanism for this service and the related data was provided to the furnishing professional | RT | Right side (used to identify procedures performed on the right side of the body) | XU | Unusual non-overlapping service, the use of a service that is distinct because it does not overlap usual components of the main service |
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| 2001-01-01 | Changed | Code description changed. |
| Pre-1990 | Added | Code added. |
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