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MR Shoulder Arthrography


Question

We have an order for an MRI with contrast of a shoulder joint.  Our radiology department charges CPT#23350 Shoulder arthrogram injection, CPT#73040 Shoulder arthrogram, 73222-RT MRI-upper ext, joint W/ contrast.  Is this the correct coding?  They do perform the arthrogram and report it, but I was wondering if we need to have an order for it?

Answer

I found two sources that indicated it was rare for a conventional arthrogram to be reported with a MR arthrography.  The most common coding for MR arthrography would be 73222 and 23350 for the shoulder injection.  If the injection was done under fluoro guidance, 77002 can be added.  If a formal diagnostic joint arthrography is done in addition to the MR arthrography, there should be a separate order for this separate diagnostic test.

Disclaimer: All articles intended for general guidance only and not as a recommendation for a specific situation. Readers should consult an official source (AHA, AMA, etc.) or a qualified attorney for specific legal guidance.
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