Coding for Magnetic Resonance Imaging

coding for magnetic resonance imaging (MRI) in CPT with woman going through the scanner
A patient lying on a motorized table is being transported into the tunnel-shaped machine known as an MRI scanner.
article at a glance summarizes what an MRI is with contrast and explains how to look up and verify the correct CPT codes for MRI

Before we discuss coding for magnetic resonance imaging, let’s talk about some essential facts about this dynamic tool and its use.

Magnetic Resonance Imaging and its Purpose

Magnetic resonance imaging (MRI) is a powerful, noninvasive tool that uses magnets, radio waves, and a computer to create detailed images of the tissues and organs in the body. Healthcare professionals use MRI scans to diagnose and monitor many conditions, ranging from torn ligaments to cancerous tumors. Unlike imaging created by X-ray and CT scans, MRI does not expose the patient to radiation.

MR imaging (MRI) is also called an MRI scan, NMR, or nuclear magnetic resonance.

According to the International Society for Magnetic Resonance in Medicine (ISMRM), approximately 10 million patients undergo MRI procedures yearly.

How Does an MRI Scanner Work? 

Most MRI scanners are large, tunnel-shaped machines, according to the Mayo Clinic. The patient lies on a motorized table that slides into the tunnel. The magnetic field temporarily realigns subatomic particles called protons in the body. Radiofrequency energy is applied, causing protons to create signals that the scanner’s receiver picks up. The scan takes cross-sectional slices (views), including 3D images. The images are stored on a computer or printed on film.

An MRI procedure takes between 15 and 45 minutes and is painless. The radiologist or technician sits in another room to watch the patient during the exam. Once the exam is complete, the specialist interprets the scans and reports to the physician. 

Injection of Contrast Materials

The specialist may use contrast materials for an MRI scan to temporarily modify how the MRI interacts within the body. Contrast materials allow for a more clear picture of the area to be examined.

Contrast materials are sometimes called contrast media, agents, or dyes.

Gadolinium contrast medium is a chemical substance that is typically used in magnetic resonance imaging exams. The agent is usually administered by connecting a small needle to an intravenous (IV) line placed in the arm or hand vein. Gadolinium is less likely to cause an allergic reaction than iodine-based contrast mediums used for X-rays and CT scans.

Safety of MRIs

MRI scans are extremely safe, and there is no radiation exposure. However, according to WebMD, certain individuals may not be good candidates for the procedure and may require a different type of exam. These individuals include those who:

  • have implanted equipment in the body, such as pacemakers, cochlear implants, artificial limbs, metal bullets, or surgical screws
  • are in the first trimester of pregnancy (MRIs are only used in the second or third trimester without contrast)
  • have had a previous allergic reaction to contrast material
  • have severe kidney disease (only MRI without contrast is safe)
  • suffer from claustrophobia, an extreme fear of confined spaces (instead, an open MRI may help with relaxation)

MRI Can Identify Many Conditions

MRI can help identify many problems in the body, including those related to the brain and spinal cord, heart and blood vessels, internal organs, bones and joints, and breasts.

According to the Children’s Hospital of Philadelphia, a fetal MRI may also be done during a woman’s second or third trimester of pregnancy to confirm a diagnosis.

Problems an MRI may discover include:

Brain and Spinal Cord 

  • aneurysms of cerebral vessels
  • eye and inner ear disorders
  • multiple sclerosis
  • spinal cord disorders
  • stroke
  • tumors
  • brain injury from trauma

MR imaging is the most frequently performed brain and spinal cord imaging test.

Heart and Blood Vessels 

  • size and function of the heart’s chambers
  • thickness and movement of the walls of the heart
  • amount of damage caused by heart attacks or heart disease
  • structural problems in the aorta, such as aneurysms or dissections
  • inflammation or blockages in the blood vessels

Internal Organs 

  • Tumors or other abnormalities in organs, such as the:
    • liver and bile ducts
    • spleen
    • kidneys
    • uterus
    • pancreas
    • ovaries
    • prostate

Bones and Joints

  • joint abnormalities due to repetitive or traumatic injuries, such as torn cartilage or ligaments
  • bone infections
  • disk abnormalities in the spine
  • tumors of the bones and soft tissues


  • breast cancer

MRI screening can be used with mammography and is performed mainly in women with dense breast tissue or those at high risk for breast cancer.


  • abnormalities in the baby’s brain, spine, or body

A fetal MRI may be used to confirm an ultrasound diagnosis or add significant diagnostic information in complex cases. MRI of the fetus is only performed in a pregnant patient during her second or third trimester.

Learn more about MRI in this short video (just over 4 minutes).  

Coding for Magnetic Resonance Imaging

MRI Codes are in the Radiology Procedures Section 

Magnetic resonance imaging (MRI) codes reside in the Radiology Procedures section of CPT. Most of the MRI codes are in the Diagnostic Radiology (Diagnostic Imaging) Procedures subsection (70010-76499) and are arranged by anatomical site based on the examined body area. 

Still, some MRI codes are located in other subsections of Radiology. For example:

  • breast MRI codes (77046-77049) are in the Breast, Mammography subsection
  • bone marrow MRI code (77084) is in the Bone/Joint Studies subsection
  • fetal MRI codes (74712-74713) are in the Gynecological and Obstetrical subsection

Coding Guidelines for Administration of Contrast

Code descriptions for MRI include “without contrast,” “with contrast,” and “without contrast and with contrast.” When an MRI is performed “without contrast,” followed by “with contrast,” one code is usually reported for both sets of images.

The coding guidelines indicate that when contrast is administered intravascularly (intravenously) for an MRI, a code should be assigned with the phrase “with contrast.”

For example, MRI of the abdomen with contrast is reported with 74182 ( Magnetic resonance (e.g., proton) imaging, abdomen; with contrast material(s).

Injection of intravascular contrast material is part of the “with contrast” MRI procedure.

Imaging Procedures Not Covered by MRI Codes

Other imaging procedures located in the Diagnostic Radiology (Diagnostic Imaging) Procedures subsection include codes for x-ray films, computer axial tomography (CAT or CT) scanning, magnetic resonance angiography (MRA), and angiography. However, these exams have their own set of codes separate from MRI codes.

How to locate and verify MRI codes in CPT

Locating and Verifying MRI Codes

Coders can find MRI codes in the CPT code book by going to the Alphabetic Index and looking up “Magnetic resonance/imaging (MRI).” Following that is a long list of code ranges for each anatomical site (see below).

Magnetic resonance
angiography (MRA)
guidance, 77021-77022
imaging (MRI), 3319F-3320F
abdomen, 74181-74183
ankle, 73721-73723
arm, 73218-73220
bone marrow, 77084
brain, 70551-70555, 70557-70559
breast, 77046-77049
chest, 71550-71552
elbow, 73221-73223
face, 70540-70543
fetal, 74712-74713
finger joint, 73221-73223
foot joint, 73721-73723
foot, 73718-73720
hand, 73218-73220
heart, 75557-75564
intraoperative, 70557-70559
knee, 73721-73723
leg, 73718-73720
lower extremity, 73718-73723
foot joint, 73721-73723
foot, 73718-73720
knee, 73721-73723
leg, 73718-73720
pelvis, 72195-72197
toe joint, 73721-73723
neck, 70540-70543
orbit, 70540-70543
pelvis, 72195-72197
spine, 72141-72158
temporomandibular joint, 70336
toe joint, 73721-73723
unlisted, 76498
upper extremity, 73218-73223
arm, 73218-73220
elbow, 73221-73223
finger joint, 73221-73223
hand, 73218-73220
wrist, 73221-73223

Once we locate our code(s) for the anatomical site, we must go to the Tabular and verify the correct code.

Common Modifiers Used with Radiology Codes

Common modifiers used in radiology are -RT and -LT to show the laterality of the anatomical site being examined. If the procedure is performed on one side, append the appropriate modifier to the CPT code.

If the procedure is performed on both sides, append modifiers -LT and -RT, or modifier -50 (based on the payer) to the CPT code unless the code descriptor indicates “bilateral” (e.g, MRI of bilateral breasts).

Modifier -XS is used when an MRI is performed on the same side of the body but with a different joint or non-joint. For example, an MRI of the right elbow and wrist should be reported as 73221, 73221-XS. (Magnetic resonance (eg, proton) imaging, any joint of upper extremity; without contrast material(s).

HCPCS Code for Contrast Material

If the name of the substance used for the contrast material is identified, a HCPCS code can be reported as a separate code. For example, a gadolinium injection for MRI is reported with A9579, Injection, gadolinium-based magnetic resonance contrast agent, not otherwise specified (nos), per ml.

MRI Coding Practice

Show what you know about coding for MRI by answering the seven coding questions below. (you are not being assessed on modifier use here) Then compare your answers to the answers and rationales provided at the bottom of this article.


  1. MRI of the foot without contrast to evaluate a lump to determine if it is benign or cancerous.
  2. A female patient with abnormal vaginal bleeding presents for an MRI of the pelvis. Gadolinium dye is used for contrast.
  3. A female patient at high risk for breast cancer receives a bilateral breast MRI without contrast.
  4. A male patient is seen for monitoring of his acute unilateral loss of vision. He receives an MRI of the brain and orbits without contrast and again after administering contrast.
  5. A patient has a cardiac MRI for morphology and function without contrast to rule out arrhythmogenic right ventricular cardiomyopathy (ARVC).
  6. A 37-year-old female with severe neck and shoulder pain receives a cervical MRI scan. The imaging is first performed without contrast and then with contrast to allow for better viewing of the cervical area. Axial, coronal, and sagittal views of the neck area are taken.
  7. The patient presents for a fetal MRI during her first pregnancy at 32 weeks. Imaging included the fetus, placenta, and maternal pelvis.


  1. 73718. The foot is made up of 26 bones, 33 joints, 107 ligaments, and 19 muscles. In the Alphabetic Index, look up Magnetic resonance/imaging (MRI)/foot, 73718-73720. In the Tabular, we can verify our correct code as 73718, Magnetic resonance (e.g., proton) imaging, lower extremity other than joint; without contrast material(s).

    Had the focus of the MRI been a joint in the foot, such as a toe joint or ankle joint, the coder would assign 73721, Magnetic resonance (e.g., proton) imaging, any joint of lower extremity; without contrast material.
  2. 72196. Look up Magnetic resonance/imaging (MRI)/pelvis, 72195-72197. In the Tabular, we can verify our correct code as 72196, Magnetic resonance (e.g., proton) imaging, pelvis; with contrast material(s).
  3. 77047. Look up Magnetic resonance/imaging (MRI)/breast, 77046-77049. In the Tabular, we can verify our correct code as 77047, Magnetic resonance imaging, breast, without contrast material; bilateral. The descriptor for 77047 includes “bilateral.”
  4. 70553, 70543. “Orbits” refer to the bony sockets of the skull in which the eye and its appendages are situated. Two MRI codes are needed for this scenario, one for the brain and one for the orbits.

    Look up MRI in the Alphabetic Index Magnetic resonance/imaging (MRI)/brain, 70551-70555, 70557-70559. In the Tabular, we can verify our correct code as 70553, Magnetic resonance (e.g., proton) imaging, brain (including brain stem); without contrast material, followed by contrast material(s) and further sequences.

    For our second code, look up MRI in the Alphabetic Index Magnetic resonance/imaging (MRI)/orbit, 70540-70543. In the Tabular, we can verify our correct code as 70543, Magnetic resonance (e.g., proton) imaging, orbit, face, and/or neck; without contrast material(s), followed by contrast material(s) and further sequences.

    According to the CPT coding guidelines, codes 70540-70543 can only be assigned once per imaging session.
  5. 75557. Arrhythmogenic right ventricular cardiomyopathy (ARVC) is a form of heart disease that affects the myocardium (heart muscle), according to MedlinePlus (National Library of Medicine). ARVC is also known as arrhythmogenic right ventricular dysplasia (ARVD) and usually appears in adulthood. ARVC/D causes a myocardium (heart muscle) breakdown over time, increasing the risk of arrhythmia (abnormal heartbeat) and sudden death.

    An MRI may be necessary when certain symptoms occur, particularly during strenuous exercise. Common symptoms include heart palpitations (feeling of a fast-beating, fluttering, or pounding heart), light-headedness, and syncope (fainting). A cardiac MRI uses a powerful magnetic field, radio waves, and a computer to create detailed images of the structures in and around the heart.

    Look up Magnetic resonance/imaging (MRI)/heart, 75557-75564. We can verify our correct code in the Tabular as 75557, Cardiac magnetic resonance imaging for morphology and function without contrast material.
  6. 72156. Look up Magnetic resonance/imaging (MRI)/spine, 72141-72158. In the Tabular, we can verify our correct code as 72156, Magnetic resonance (e.g., proton) imaging, spinal canal, and contents, without contrast material, followed by contrast material(s) and further sequences; cervical.
  7. 74712. Look up Magnetic resonance/imaging (MRI)/fetal, 74712-74713. When we go to these codes in the Tabular, we can verify our correct code as 74712, Magnetic resonance (e.g., proton) imaging, fetal, including placental and maternal pelvic imaging when performed; single or first gestation. Do not report 74712 and/or 74713 in conjunction with 72195, 72196, or 72197.


Hopefully, now you better understand MR imaging and how it helps diagnose and monitor many different conditions. Furthermore, you know what contrast materials are and that they are typically injected into a vein in the arm or hand for an MRI study. Finally, you can look up and verify the correct CPT codes in the coding manual based on the provider’s documentation.

MRI coding in CPT and 7 questions to answer from the Radiology section.

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