CPT Code for MRI Lumbar Spine Without Contrast: 72148

The CPT code for an MRI of the lumbar spine without contrast is 72148. This code is used when a magnetic resonance imaging study of the lumbar spinal canal and contents is performed without the injection of contrast material. It is one of several codes for spine MRI, each specifying the spinal region and whether contrast is used.

Understanding the correct CPT code is essential for accurate billing and reimbursement. This article explains the details of code 72148, when it is appropriate, how it compares to related codes, and what to expect during the procedure.

What Is CPT Code 72148?

CPT code 72148 is defined as "Magnetic resonance imaging, spinal canal and contents, lumbar; without contrast material." It covers an MRI of the lumbar spine (lower back) performed without the use of intravenous contrast. The procedure uses a magnetic field and radio waves to create detailed images of the vertebrae, intervertebral discs, spinal cord, and nerve roots in the lumbar region.

According to Noridian Medicare, this code is reported for MRI diagnostic imaging of the lumbar spine without contrast. It is a common study for evaluating low back pain, radiculopathy, and suspected disc herniation.

When Is 72148 Used?

Code 72148 is used when the referring physician orders an MRI of the lumbar spine without contrast. This is typically the initial imaging study for patients with:

• Low back pain without red flags
• Symptoms of a pinched nerve (radiculopathy)
• Suspected degenerative disc disease
• Evaluation of disc herniation

As noted by Guilford Radiology, MRI of the lumbar spine is extremely useful for evaluating low back pain or symptoms of a pinched nerve, and it can accurately assess degenerative disc disease and disc herniation. In many cases, contrast is not needed for these indications.

Contrast is typically reserved for cases where there is a history of cancer, infection, prior surgery, or suspected inflammatory conditions. If contrast is required, a different code is used.

Comparison of Lumbar Spine MRI CPT Codes

There are three main CPT codes for lumbar spine MRI, depending on contrast use:

This table is supported by multiple sources, including Lexington Diagnostic and Main Street Radiology. Note that 72158 is used when both non-contrast and contrast-enhanced images are obtained during the same session.

For other spinal regions, the codes are:

• Cervical spine: 72141 (without), 72142 (with), 72156 (without and with)
• Thoracic spine: 72146 (without), 72147 (with), 72157 (without and with)

It is important to select the code that matches the exact procedure performed. Billing for contrast when not administered, or vice versa, can lead to claim denials.

What Does a Lumbar Spine MRI Without Contrast Involve?

During a lumbar spine MRI without contrast, the patient lies on a table that slides into the MRI machine. No injection is given. The scan typically takes 30 to 60 minutes, and the patient must remain still. The MRI machine makes loud tapping noises, so earplugs or headphones are often provided.

According to Guilford Radiology, patients should remove all metal objects, including jewelry and clothing with metal zippers or buttons. They may be given a gown to wear. There is no special preparation required, and patients can resume normal activities immediately after the scan.

Because no contrast is used, there is no risk of allergic reaction or nephrogenic systemic fibrosis, which are rare complications associated with gadolinium-based contrast agents.

Billing and Coding Considerations

Accurate coding for MRI lumbar spine without contrast requires attention to the following:

• Documentation: The radiology report should clearly state that no contrast was administered.
• Medical necessity: The ordering diagnosis must support the need for MRI. Common ICD-10 codes include M54.5 (low back pain), M51.16 (intervertebral disc disorder with radiculopathy), and M48.06 (spinal stenosis).
• Modifiers: If the study is performed bilaterally or in multiple regions, appropriate modifiers may be needed, but 72148 is inherently unilateral for the lumbar spine.
• Contrast codes: If contrast is given, use 72149 or 72158 as appropriate. Do not report 72148 with contrast.

For assistance with pricing or coding questions, facilities like Lexington Diagnostic provide billing support. It is advisable to verify coverage with the patient's insurance, as some payers may require prior authorization for lumbar MRI.

Frequently Asked Questions

Is CPT 72148 the same as a lumbar spine MRI without dye?

Yes, "without contrast" means without dye. The terms are interchangeable in this context.

Can a lumbar spine MRI be done without contrast?

Yes, most lumbar spine MRIs are performed without contrast. Contrast is only needed for specific indications such as suspected tumor, infection, or post-surgical evaluation.

What is the difference between 72148 and 72158?

72148 is for MRI without contrast only. 72158 is for MRI performed first without contrast and then with contrast, in the same session.

Is CPT 72148 covered by Medicare?

Medicare may cover 72148 if medically necessary. Coverage policies vary by region, so it is best to check with the local Medicare Administrative Contractor (MAC).

For more detailed coding guidance, refer to the CPT Code Guidelines for MRI provided by Lake Medical Imaging.