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72133
Quick jump to procedure code: Printer Friendly Version
72142

CPT® 72141: MAGNETIC RESONANCE (EG, PROTON) IMAGING, SPINAL CANAL AND CONTENTS, CERVICAL; WITHOUT CONTRAST MATERIAL

Short Description: Mri neck spine w/o dye

--

CPT copyright 2015 American Medical Association. All rights reserved.


Medicare Reimbursement Information         Hide this section.

ALABAMA-Entire State
ALASKA-Entire State
ARIZONA-Entire State
ARKANSAS-Entire State
CALIFORNIA NORTH-Marin/Napa/Solano
CALIFORNIA NORTH-San Francisco
CALIFORNIA NORTH-San Mateo
CALIFORNIA NORTH-Oakland/Berkeley
CALIFORNIA NORTH-Santa Clara
CALIFORNIA NORTH-Rest of North California
CALIFORNIA SOUTH-Ventura
CALIFORNIA SOUTH-Los Angeles
CALIFORNIA SOUTH-Anaheim/Santa Ana
CALIFORNIA SOUTH-Rest of South California
COLORADO-Entire State
CONNECTICUT-Entire State
DELAWARE-Entire State
DIST of COL-DC + MD/VA Suburbs
FLORIDA-Ft Lauderdale
FLORIDA-Miami
FLORIDA-Rest of Florida
GEORGIA-Atlanta
GEORGIA-Rest of Georgia
HAWAII/GUAM-Entire State/Terr.
IDAHO-Entire State
ILLINOIS-East St. Louis
ILLINOIS-Suburban Chicago
ILLINOIS-Chicago
ILLINOIS-Rest of Illinois
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LOUISIANA-Rest of Louisiana
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MAINE-Rest of Maine
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MARYLAND-Rest of Maryland
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MICHIGAN-Rest of Michigan
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WASHINGTON-Seattle (King County)
WASHINGTON-Rest of Washington
WEST VIRGINIA-Entire State
WISCONSIN-Entire State
WYOMING-Entire State

2016 Physician
Fee Schedule:

Global Fee $225.00
* 26 Modifier $ 75.96
* TC Modifier $149.04

2016 Wage Index Adjustment for Outpatient Prospective Payment System (OPPS) and Ambulatory Surgical Center (ASC) Payments
Zip Code:
2016 Unadjusted OPPS Payment $273.54
2016 Unadjusted ASC Payment $148.66


*Based on National 2013 Medicare Part B submitted claims.
Revenue Code(s):
612-MRT/MRI-spinal cord (including spine)


2016 APC Code: 5581
Magnetic Resonance Imaging and Magnetic Resonance Angiography without Contrast

Composite APC: 8007
MRI and MRA without Contrast Composite

2016 OPPS Status Indicator: Q3

* This procedure is subject to the Multiple Procedure Payment Reduction (MPPR) on Certain Diagnostic Imaging Procedures - CMS Transmittal 1104

Effective April 1, 2013, and while sequestration is in effect, all CMS payments for services will be reduced by 2%. The fees above do not reflect this reduction. Click here for more information.

Commonly Associated Diagnosis Codes*            Hide this section.
PercentageICD-9ICD-10 Conversions
16.5% 723.1    Cervicalgia M54.2   Cervicalgia
12.6% 722.4    Degeneration of cervical intervertebral disc M50.30   Other cervical disc degeneration, unspecified cervical region
10.2% 722.0    Displacement of cervical intervertebral disc without myelopathy M50.20   Other cervical disc displacement, unspecified cervical region
9.5% 721.0    Cervical spondylosis without myelopathy M47.812   Spondylosis without myelopathy or radiculopathy, cervical region
9.3% 723.0    Spinal stenosis of cervical region M48.02   Spinal stenosis, cervical region
5.9% 723.4    Brachia neuritis or radiculitis, not otherwise classified M54.12   Radiculopathy, cervical region
OR:
M54.13   Radiculopathy, cervicothoracic region
2.2% 782.0    Disturbance of skin sensation R20.0   Anesthesia of skin
OR:
R20.1   Hypoesthesia of skin
OR:
R20.2   Paresthesia of skin
OR:
R20.3   Hyperesthesia
OR:
R20.8   Other disturbances of skin sensation
OR:
R20.9   Unspecified disturbances of skin sensation
1.7% 722.91    Other and unspecified disc disorder, cervical region M50.80   Other cervical disc disorders, unspecified cervical region
OR:
M50.90   Cervical disc disorder, unspecified, unspecified cervical region
1.6% 724.2    Lumbago M54.5   Low back pain
1.2% 719.41    Pain in joint, shoulder region M25.519   Pain in unspecified shoulder

* Commonly Associated ICD-10 codes derived from 2010 Physician Supplier Part B Medicare claims data and 2015 CMS General Equivalency Mapping Codes (GEM).
This data represents an analysis of 43 million claims processed for 1.7 million beneficiaries in 2010.

Medicare Coverage Policy Information         Hide this section.
No contractor selected.

72141 not found in an Local Coverage Determination (LCD) for your contractor. Other contractors covering 72141

CCI and MUE Edits*         Hide this section.

CCI Edits for 72141
Denied Codes (1)
Effective
Modifier
Accepted (2)
01922 Anesth cat or mri scan
07/01/2002 No
36591 Draw blood off venous device
10/01/2015 No
36592 Collect blood from picc
10/01/2015 No
72142 Mri neck spine w/dye
01/01/1996 No
72156 Mri neck spine w/o & w/dye
01/01/1996 No
 
Denied Codes (1)
Effective
Modifier
Accepted (2)
72159 Mr angio spine w/o&w/dye
07/01/2011 Yes
C8931 Mra, w/dye, spinal canal
07/01/2011 Yes
C8932 Mra, w/o dye, spinal canal
07/01/2011 Yes
C8933 Mra, w/o&w/dye, spinal canal
07/01/2011 Yes
(1) These codes will be denied when submitted for payment on the same date of service as 72141.

(2) "Yes" indicates that the use of a modifier with the denied code will overcome the edit and allow payment.
"No" indicates that the second code will always be denied.


Medically Unlikely Edits for 72141


Practitioner
Hospital Outpatient
DME Supplier
Allowed Frequency per Day: 1 1 Not Listed
Adjudication Indicator: 3 Date of Service Edit: Clinical 3 Date of Service Edit: Clinical Not Listed
Rationale: Anatomic Consideration Anatomic Consideration Not Listed

* The responsibility for the content of any "National Correct Coding Policy" included in this product is with the Centers for Medicare and Medicaid Services and no endorsement by the AMA is intended or should be implied. The AMA disclaims responsibility for any consequences or liability attributable to or related to any use, nonuse, or interpretation of information contained in this product.


   72141 Top 5 Ordering Providers National*
STEPHEN HERSHOWITZ -MELVILLE,NY 733
RICHARD SILVERGLEID -GARDEN CITY,NY 730
HAROLD TICE -LYNBROOK,NY 592
EDGARDO ANGTUACO -LITTLE ROCK,AR 567
TIMOTHY GREENAN -ROCKVILLE,MD 536

   72141 Top 5 Ordering Organizations National*
ROSE RADIOLOGY CENTERS INC-FL 792
INOVA HEALTH CARE SERVICES-VA 560
MAINE MOBILE MRI ASSOCIATES-ME 431
UNIVERSITY RADIOLOGY NETWORK INC-CA 419
CAROLINA IMAGING LLC OF FAYETTEVILLE-NC 395

*Based on 2014 Medicare Fee-For Service Provider Utilization & Payment Data, Physician and Other Supplier, Public Use File



   Medicare Part B Utilization Data for 72141*         Hide this section.


Annual Procedures / Tests Performed / Denied


Total National Services (all modifiers) Submitted 2014: 632,127
Total Services Denied 2014: 37,723 (6.0%)
National Charges Submitted 2014: $491,050,635.00
National Charges Allowed 2014: $ 76,771,831.00
National Average (No Modifier) Fee Submitted 2014: $1431.92
National Average (No Modifier) Fee Allowed 2014: $252.83
National Average (26) Fee Submitted 2014: $309.66
National Average (26) Fee Allowed 2014: $ 71.69
National Average (TC) Fee Submitted 2014: $1363.65
National Average (TC) Fee Allowed 2014: $150.58


Top 5 Performing Specialties 2014 Total Tests Percent
of Total
Average
Amount
Submitted
Denials Percent
Denied
Diagnostic radiology 491,452 77.7% $613.59 25,942 5.3%
Independent Diagnostic Testing Facility
(IDTF)
(eff. 6/98)
76,098 12.0% $1579.63 7,915 10.4%
Orthopedic surgery 21,868 3.5% $1202.92 1,165 5.3%
Neurology 11,803 1.9% $934.07 679 5.8%
Interventional radiology
(eff 5/92)
5,489 0.9% $575.94 230 4.2%

Top 5 Places of Service 2014 Total Tests Percent
of Total
Average
Amount
Submitted
Denials Percent
Denied
Office 313,448 49.6% $1199.14 23,829 7.6%
Outpatient hospital 241,131 38.1% $308.60 8,966 3.7%
Inpatient hospital 51,422 8.1% $314.40 2,869 5.6%
Emergency room - hospital 13,151 2.1% $311.64 891 6.8%
Other unlisted facility 1,122 0.2% $1878.47 72 6.4%

Top 5 Modifiers Submitted 2014 Total Tests Percent
of Total
Average
Amount
Submitted
Denials Percent
Denied
26 - Professional Component 365,539 57.8% $309.66 15,424 4.2%
No Modifier 143,318 22.7% $1431.92 16,025 11.2%
TC - Technical Component 65,816 10.4% $1363.65 4,948 7.5%
51 - Multiple Procedures 47,537 7.5% $1460.78 409 0.9%
GA - Advanced Beneficiary Notice (ABN) on File 3,416 0.5% $1154.90 217 6.4%

Click here for more information on Custom CodeMap Medicare Utililation Reports.


*Utilization data is derived from analysis of the Physician Supplier Procedure Summary Master File (PSPSMF) which includes data from all Medicare Part B carriers. This data represents procedure-specific billing data for all physician/supplier services rendered to all Medicare beneficiaries during the calendar year named and processed by the Carriers through the six months of the following year.

Part B charge and utilization data for institutional services (hospital outpatient departments, home health agencies, comprehensive outpatient rehabilitation facilities, end-stage renal disease facilities, and rural health clinics) are processed by Medicare Part A fiscal intermediaries and are not included in this data. Data for services rendered to beneficiaries enrolled in risk-based Health Maintenance Organizations (HMOs) are also not included.


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All information on this web site is compiled directly from information obtained from the Center for Medicare and Medicaid Services (CMS) and from its Contractors.

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