July 25, 2025
When it comes to radiology billing, precision matters. CPT Code 72146 plays a vital role in diagnostic imaging, especially for patients dealing with back pain, suspected disc issues, or nerve root impingement. Whether you’re a medical biller, radiology tech, or provider, understanding this code helps ensure clean claims and quicker reimbursements.
CPT Code 72146 is defined as:
Magnetic resonance (e.g., proton) imaging, spinal canal and contents, lumbar; without contrast material.
In simpler terms, it’s used when a patient undergoes an MRI of the lumbar spine without contrast. This scan helps detect disc herniation, spinal stenosis, tumors, or inflammation.
The following healthcare providers and facilities can bill for 72146 CPT code:
Appropriate credentialing and NPI registration are important before billing.
When billing CPT Code 72146, it typically includes:
Unlike time-based CPT codes used in physical therapy or behavioral health, CPT Code 72146 does not depend on the length of the session.
However, a full diagnostic scan that meets clinical guidelines must be completed and documented.
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Modifiers help specify what portion of the service was provided. Use them correctly to avoid denials:
Mistakes in radiology billing are costly. Now are common issues to see for right billing proces:
Reimbursement varies by payer and region, but here’s a general idea:
Payer Type | Approximate Reimbursement |
Medicare | $200 – $250 (global rate) |
Private Payers | $350 – $500+ (varies widely) |
Note: If only the technical or professional component is billed, expect lower rates based on the modifier used.
Understanding the distinctions helps prevent miscoding:
CPT Code | Description |
72146 | MRI lumbar spine without contrast |
72148 | MRI lumbar spine with contrast |
72158 | MRI lumbar spine with and without contrast |
70551 | MRI brain without contrast (MRI brain CPT code) |
73721 | MRI knee without contrast (CPT code MRI of knee) |
74183 | MRI stomach with & without dye (CPT for MRI abdomen) |
Always refer to the CPT code lookup 72146 in your EHR or coding software to confirm usage guidelines.
Billing the CPT CODE correctly improves approval rates and reduces audits. Here’s how:
CPT Code 72146 is foundational in spinal imaging. It clarifies diagnosis and directs appropriate treatment plans. Whether you’re a biller, coder, or physician, understanding the correct use of this code ensures smoother workflows and better financial outcomes.
If you’re looking to streamline your radiology billing, reduce denials, or need help with coding audits, our team at Cures Medical Billing is here to help. We specialize in clean claim submissions and ensure your documentation meets payer scrutiny.
Need help coding CPT 72146 or others like MRI brain or abdomen scans?
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CPT Code 72146 is typically used when a provider suspects spinal issues in the lumbar region, such as disc herniation, nerve root compression, spinal stenosis, or chronic lower back pain. Clinical signs like radiating leg pain, numbness, or neurological deficits are strong justifications for this scan.
No, billing 72146 (without contrast) and 72148 (with contrast) together for the same spinal MRI session is not allowed. If the MRI is performed both with and without contrast, the correct code is 72158, which includes both components.
Not always, but many commercial payers and Medicare Advantage plans do require prior authorization. It’s best practice to verify this with the patient’s insurance ahead of time, especially for outpatient imaging services. Failing to obtain auth can lead to denials even if the scan was medically necessary.
Yes, if a patient has had lumbar spine surgery and presents with new or ongoing symptoms, CPT 72146 may be appropriate. However, some payers may prefer contrast-enhanced scans post-op to detect scar tissue vs. recurrent disc issues, in which case 72148 or 72158 would apply.
In most states, chiropractors can order an MRI if within their scope of practice, but billing CPT 72146 is typically restricted to radiologists or imaging facilities. Physical therapists generally cannot bill for this code, but they can review MRI results for treatment planning.
You’ll need a detailed provider note showing medical necessity, including symptoms, physical exam findings, and a clinical reason for imaging. Also, radiology reports must be finalized and signed by the interpreting physician. Missing or vague documentation is one of the top causes of denials.
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