AMA Clinical Examples in Radiology - 2005 Issue 2 (Spring)
Magnetic Resonance (MR) Shoulder Arthrography
Magnetic Resonance (MR) Shoulder Arthrography Intra-articular contrast (dye injected directly into the shoulder joint) adds considerable clinical information to conventional plain film, computed tomography (CT), or MR studies of the shoulder. MR arthrography is now considered the optimal technique for evaluation of the cartilage of the shoulder joint. A 54-year-old male with chronic left shoulder pain and recurrent dislocation is referred for advanced shoulder imaging with MR arthrography. Previous plain film examinations have been negative and labral cartilaginous injury is suspected. Indication Left shoulder recurrent dislocation Technique 76003 Under fluoroscopic guidance, using 1% local lidocaine anesthesia, a needle was...
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Article Overview
This premium coding article explains a shoulder MR arthrography example and the associated radiology billing context. It is aimed at coders, billers, and imaging professionals who need to understand how shoulder arthrography services are organized across CPT and HCPCS Level II, including the distinction between the injection procedure, MR imaging with contrast, fluoroscopic guidance, and contrast supply reporting. The discussion also addresses Medicare-related considerations, cross-references, and how combination studies are handled at a high level.
Why This Topic Matters
Shoulder arthrography cases often involve multiple components that may be reported differently depending on the study performed and payer context. Understanding the article helps avoid incomplete or duplicative reporting for radiology services and contrast supplies.
Article Sections
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Indication and Technique
Introduces the clinical scenario and outlines the imaging workflow used in the shoulder arthrography example. Covers the broad procedural setup and sequence of studies without detailing coding choices.
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Findings
Summarizes the imaging observations from the example case. Focuses on the general diagnostic context of the shoulder study.
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Impression
Presents the overall radiology impression from the example. This section reflects the clinical endpoint of the imaging study.
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How to Code
Provides the coding framework associated with the example, including the relevant CPT and HCPCS Level II reporting categories. Also covers the broad relationship between the procedure components and the coding references cited in the article.
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Discussion
Explains broader coding context for arthrography services, including radiology guidance references, Medicare-related considerations, and how the article positions fluoroscopy and contrast reporting.
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Coding Tip
Highlights general reporting notes relevant to arthrography workflows and combined imaging scenarios. Emphasizes the article’s broader guidance themes without reproducing specific instructions.
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Table 13
Presents a quick-reference table of arthrography-related procedures by joint and imaging category. The table is included as part of the article’s broader coding reference structure.
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Contrast Reporting
Discusses the reporting context for contrast supplies in different settings and payer environments. Includes Medicare-related and HCPCS Level II-related reporting themes at a general level.
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Endnotes
Lists source references and publication notes supporting the article. This section provides citation context rather than substantive coding guidance.
What You Will Learn
- How a shoulder MR arthrography example is organized for coding reference
- Which general service components are discussed in the article
- How the article frames fluoroscopy, contrast, and imaging reporting at a high level
- What payer and setting considerations are mentioned for contrast supply reporting
- What reference materials and coding sources the article cites
Who Should Read This
- Medical coders
- Radiology billers
- Imaging department staff
- Compliance and reimbursement professionals
- Healthcare providers involved in diagnostic imaging documentation
Codes Discussed
Code Ranges Discussed
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