Certified Professional Coder (CPC) Practice Test

What would be the code for an MRI of the pelvis with contrast materials for the physician service only?

1. 72196

2. 72196-26

3. 72197

4. 72197-26

The correct answer is: 72196-26

The correct code for an MRI of the pelvis with contrast for the physician service only is identified as 72196-26. This coding reflects specific elements of the procedure being performed and the context in which the service is provided. In this instance, 72196 is the base code for an MRI of the pelvis without contrast. However, when a contrast material is utilized, a more detailed coding is required, typically using the next higher code, which is 72197 for an MRI of the pelvis with contrast. The physician's service is denoted by the suffix -26, indicating that this charge is for the professional component only, which is separate from the technical component involved in the MRI procedure. The inclusion of the -26 modifier is crucial here as it distinguishes the service provided by the physician from the facility or technical service that involves the use of equipment. Thus, when a physician performs this MRI using contrast media, they would code it as 72197 but specify that it is the professional component by appending the -26 modifier. This highlights the importance of correctly interpreting coding guidelines to ensure the proper representation of medical services, allowing for accurate reimbursement and preventing any coding errors.