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Magnetic resonance imaging (MRI) is a sophisticated imaging technique utilized to visualize the internal structures of the body, particularly the lower extremities, excluding the joints. This noninvasive procedure leverages the magnetic properties of hydrogen atoms present in the body, allowing for detailed imaging without the use of ionizing radiation. During the MRI process, the patient is positioned on a motorized table that moves into a large cylindrical scanner, which houses a powerful magnet. The magnetic field generated by the scanner aligns the hydrogen atoms in the body. Subsequently, radiowaves are transmitted into this magnetic field, causing the protons within the hydrogen nuclei to emit specific radiofrequency signals. These signals are captured and processed by a computer, which constructs high-resolution, three-dimensional images of the scanned area. In the context of CPT® Code 73718, the MRI is specifically focused on the lower extremity, such as the upper or lower leg, and does not involve the use of contrast material. This is a critical distinction, as the absence of contrast differentiates it from other related codes, such as CPT® Code 73719, which involves the administration of iodine contrast dye, and CPT® Code 73720, which includes both non-contrast and contrast imaging. MRI scans are particularly valuable for diagnosing a variety of conditions, including injuries, trauma, and unexplained pain, as they provide clear images of soft tissues, muscles, and bones that may not be adequately visualized through other imaging modalities like CT scans. The detailed images produced by MRI can assist physicians in identifying issues such as tendinitis, muscle atrophy, soft tissue lesions, osteomyelitis, contusions, hematomas, and fractures, thereby facilitating accurate diagnosis and treatment planning.
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Magnetic resonance imaging (MRI) of the lower extremity, as described by CPT® Code 73718, is indicated for a variety of clinical scenarios. The following conditions and symptoms may warrant the use of this imaging technique:
The procedure for conducting an MRI of the lower extremity without contrast, as per CPT® Code 73718, involves several key steps that ensure accurate imaging results. The patient begins by being positioned comfortably on a motorized table, which is designed to slide into the MRI scanner. This scanner is a large, cylindrical machine that contains a powerful magnet. Once the patient is in place, the technician ensures that the area of interest, in this case, the lower leg, is properly aligned within the magnetic field. Next, small coils may be placed around the leg to enhance the quality of the images by improving the transmission and reception of the radiowaves. The MRI machine is then activated, generating a strong magnetic field that aligns the hydrogen atoms in the body. Following this, radiowaves are emitted into the area being scanned. The protons in the hydrogen nuclei respond to these radiowaves by emitting signals, which are captured by the MRI machine. The computer processes these signals to create detailed, high-resolution images of the lower extremity. The entire procedure typically lasts between 30 to 60 minutes, depending on the specific protocols used and the complexity of the imaging required. Throughout the process, the patient is instructed to remain still to avoid motion artifacts that could compromise image quality. After the imaging is complete, the patient is carefully slid out of the scanner, and the images are reviewed by a physician for diagnostic interpretation.
After the MRI procedure is completed, there are generally no specific post-procedure care requirements, as the process is noninvasive and does not involve the use of contrast material. Patients can typically resume their normal activities immediately following the scan. However, it is advisable for patients to discuss any concerns or symptoms with their healthcare provider, especially if they are awaiting results or further diagnostic evaluations. The physician will review the MRI images and provide a report detailing any findings, which will be used to guide further treatment or management of the patient's condition. Follow-up appointments may be scheduled to discuss the results and any necessary next steps in the patient's care plan.
Short Descr | MRI LOWER EXTREMITY W/O DYE | Medium Descr | MRI LOWER EXTREM OTH/THN JT W/O CONTR MATRL | Long Descr | Magnetic resonance (eg, proton) imaging, lower extremity other than joint; without 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) | 3 - The usual 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 OPPS relative payment weight. | Type of Service (TOS) | 4 - Diagnostic Radiology | Berenson-Eggers TOS (BETOS) | I2D - Advanced imaging - MRI/MRA: other | MUE | 2 | 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. | LT | Left side (used to identify procedures performed on the left side of the body) | RT | Right side (used to identify procedures performed on the right side of the body) | 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 | 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). | 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 | ME | The order for this service adheres to appropriate use criteria in the clinical decision support mechanism consulted by the ordering professional | GC | This service has been performed in part by a resident under the direction of a teaching physician | 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 | 50 | Bilateral procedure: unless otherwise identified in the listings, bilateral procedures that are performed at the same session, should be identified by adding modifier 50 to the appropriate 5 digit code. note: this modifier should not be appended to designated "add-on" codes (see appendix d). | 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. | X4 | Episodic/focused services: for reporting services by clinicians who provide focused care on particular types of treatment limited to a defined period and circumstance; the patient has a problem, acute or chronic, that will be treated with surgery, radiation, or some other type of generally time-limited intervention; reporting clinician service examples include but are not limited to, the orthopedic surgeon performing a knee replacement and seeing the patient through the postoperative period | GA | Waiver of liability statement issued as required by payer policy, individual case | 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). | 76 | Repeat procedure or service by same physician or other qualified health care professional: it may be necessary to indicate that a procedure or service was repeated by the same physician or other qualified health care professional subsequent to the original procedure or service. this circumstance may be reported by adding modifier 76 to the repeated procedure or service. note: this modifier should not be appended to an e/m service. | Ordering professional consulted a qualified clinical decision support mechanism for this service and the related data was provided to the furnishing professional | 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. | XS | Separate structure, a service that is distinct because it was performed on a separate organ/structure | 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 | 53 | Discontinued procedure: under certain circumstances, the physician or other qualified health care professional may elect to terminate a surgical or diagnostic procedure. due to extenuating circumstances or those that threaten the well being of the patient, it may be necessary to indicate that a surgical or diagnostic procedure was started but discontinued. this circumstance may be reported by adding modifier 53 to the code reported by the individual for the discontinued procedure. note: this modifier is not used to report the elective cancellation of a procedure prior to the patient's anesthesia induction and/or surgical preparation in the operating suite. for outpatient hospital/ambulatory surgery center (asc) 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). | 99 | Multiple modifiers: under certain circumstances 2 or more modifiers may be necessary to completely delineate a service. in such situations modifier 99 should be added to the basic procedure, and other applicable modifiers may be listed as part of the description of the service. | AQ | Physician providing a service in an unlisted health professional shortage area (hpsa) | CC | Procedure code change (use 'cc' when the procedure code submitted was changed either for administrative reasons or because an incorrect code was filed) | CR | Catastrophe/disaster related | FT | Unrelated evaluation and management (e/m) visit on the same day as another e/m visit or during a global procedure (preoperative, postoperative period, or on the same day as the procedure, as applicable). (report when an e/m visit is furnished within the global period but is unrelated, or when one or more additional e/m visits furnished on the same day are unrelated) | FY | X-ray taken using computed radiography technology/cassette-based imaging | GQ | Via asynchronous telecommunications system | GV | Attending physician not employed or paid under arrangement by the patient's hospice provider | GW | Service not related to the hospice patient's terminal condition | KX | Requirements specified in the medical policy have been met | MA | Ordering professional is not required to consult a clinical decision support mechanism due to service being rendered to a patient with a suspected or confirmed emergency medical condition | MB | Ordering professional is not required to consult a clinical decision support mechanism due to the significant hardship exception of insufficient internet access | MC | Ordering professional is not required to consult a clinical decision support mechanism due to the significant hardship exception of electronic health record or clinical decision support mechanism vendor issues | 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 | Q5 | Service furnished under a reciprocal billing 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 | QJ | Services/items provided to a prisoner or patient in state or local custody, however the state or local government, as applicable, meets the requirements in 42 cfr 411.4 (b) | T1 | Left foot, second digit | T5 | Right foot, great toe | T6 | Right foot, second digit | T7 | Right foot, third digit | TL | Early intervention/individualized family service plan (ifsp) | XE | Separate encounter, a service that is distinct because it occurred during a separate encounter | XP | Separate practitioner, a service that is distinct because it was performed by a different practitioner | 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 | Added | First appearance in code book in 2001. |
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