Introduction
Medical imaging procedures, including MRI, CT, and ultrasound, are critical for diagnosing a wide range of conditions. Correct CPT coding ensures proper reimbursement and prevents claim denials due to bundling or incorrect modifier use. This guide covers key CPT codes for MRI, CT, and ultrasound, along with billing guidelines, modifier use, and a final reference table including CPT descriptions and RVUs.
Understanding MRI, CT, and Ultrasound Coding
Magnetic Resonance Imaging (MRI), Computed Tomography (CT), and ultrasound scans are used to visualize internal structures. The appropriate CPT code depends on factors such as anatomical location, contrast use, and procedural complexity.
CPT Codes for MRI, CT, and Ultrasound
MRI CPT Codes
- 70551 – MRI brain, without contrast.
- 70552 – MRI brain, with contrast.
- 70553 – MRI brain, with and without contrast.
- 72141 – MRI cervical spine, without contrast.
- 72142 – MRI cervical spine, with contrast.
- 72146 – MRI lumbar spine, without contrast.
- 72147 – MRI lumbar spine, with contrast.
CT Scan CPT Codes
- 70450 – CT head or brain, without contrast.
- 70460 – CT head or brain, with contrast.
- 70470 – CT head or brain, with and without contrast.
- 72125 – CT cervical spine, without contrast.
- 72126 – CT cervical spine, with contrast.
- 72128 – CT lumbar spine, without contrast.
- 72129 – CT lumbar spine, with contrast.
Ultrasound CPT Codes
- 76700 – Abdominal ultrasound, complete.
- 76705 – Abdominal ultrasound, limited.
- 76856 – Pelvic ultrasound, complete.
- 76857 – Pelvic ultrasound, limited.
- 93880 – Carotid artery ultrasound, bilateral.
- 93970 – Extremity venous ultrasound, bilateral.
Billing Guidelines & Modifier Usage
-
Common Modifiers:
- -TC – Technical component only.
- -26 – Professional component only.
- -52 – Reduced service when a full exam is not completed.
-
Bundling Considerations:
- CT and MRI scans performed on the same day may be bundled by some payers—check policies before billing separately.
- Some payers require medical necessity documentation for contrast studies.
Common Denials & How to Avoid Them
- Medical Necessity Denials: Ensure documentation includes clinical indications and prior imaging results.
- Modifier Issues: Always append -26 or -TC if billing professional or technical components separately.
- Duplicate Claim Rejections: Avoid resubmitting the same scan without medical necessity justification.
Final CPT Code Table: Descriptions & RVUs
| CPT Code | Description | RVU |
|---|---|---|
| 70551 | MRI brain, without contrast | 12.00 |
| 70552 | MRI brain, with contrast | 14.50 |
| 70553 | MRI brain, with and without contrast | 17.20 |
| 72141 | MRI cervical spine, without contrast | 13.40 |
| 72142 | MRI cervical spine, with contrast | 15.80 |
| 72146 | MRI lumbar spine, without contrast | 13.20 |
| 72147 | MRI lumbar spine, with contrast | 15.60 |
| 70450 | CT head or brain, without contrast | 7.85 |
| 70460 | CT head or brain, with contrast | 9.60 |
| 70470 | CT head or brain, with and without contrast | 11.80 |
| 76700 | Ultrasound, abdominal, complete | 6.75 |
| 76705 | Ultrasound, abdominal, limited | 5.40 |
| 76856 | Ultrasound, pelvic, complete | 6.90 |
| 76857 | Ultrasound, pelvic, limited | 5.60 |
| 93880 | Ultrasound, carotid arteries, bilateral | 9.20 |
| 93970 | Extremity venous ultrasound, bilateral | 8.50 |
Conclusion
Accurate CPT coding for MRI, CT, and ultrasound is essential for maximizing reimbursement and reducing denials. Understanding modifier use, bundling rules, and payer-specific guidelines will help ensure accurate claims.
If this guide was useful, check out our other radiology CPT coding guides on fluoroscopy, mammography, and PET scans!