August 5, 2025
CPT Code 72156 refers to Magnetic Resonance Imaging (MRI) of the brain with and without contrast material. This diagnostic imaging service helps evaluate detailed anatomical structures of the brain to diagnose abnormalities such as tumors, aneurysms, or multiple sclerosis.
Understanding CPT Code 72156 is important in billing, especially for radiologists and outpatient facilities. It ensures accurate claim submission, prevents denials, and supports clinical necessity documentation.
The following providers are typically eligible to bill CPT Code 72156:
Always verify payer guidelines before billing.
This code covers an MRI of the brain before and after contrast material is administered. The service includes:
This procedure is usually performed when the pre-contrast images show abnormalities requiring further clarification or when clinical indications support contrast use.
Depending on payer policies, modifiers may be required:
Using the correct modifiers helps avoid denials and ensures each part of the procedure is properly reimbursed.
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Avoid these errors to ensure timely reimbursement:
Reimbursement rates can vary by payer. On average:
Ensure you check payer-specific fee schedules or use a CPT code lookup tool.
|
Code |
Description |
|
MRI brain without contrast only |
|
|
72149 |
MRI brain with contrast only |
|
70553 |
MRI brain with and without contrast (alternative) |
Understanding these differences helps avoid incorrect billing or duplication.
CPT Code 72156 is an essential code in radiology billing, especially for brain imaging that requires contrast. Accurate documentation, proper modifier use, and an understanding of payer guidelines are vital to successful claim processing. Avoid mutual mistakes and stay informed of reimbursement policies.
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Contact Cures Medical Billing for expert guidance on codes like 72156, 72141, 72148, and CT procedures. We’re here to help you get paid accurately, every time.
CPT Code 72156 refers to an MRI scan of the brain performed both with and without contrast material. This code is used when a detailed view of brain structures is required, typically for evaluating conditions like tumors, vascular abnormalities, or unexplained neurological symptoms.
Unlike CPT 70551 (MRI brain without contrast) or CPT 70553 (MRI brain with and without contrast for more complex protocols), 72156 specifically covers MRI of the spine (cervical, thoracic, or lumbar) with and without contrast. It’s often confused with brain MRI codes but applies to spinal imaging, not the brain.
Licensed radiologists, diagnostic imaging centers, outpatient facilities, and hospital-based departments may bill CPT Code 72156, provided the procedure is performed and documented appropriately. The interpreting provider must include both the pre-contrast and post-contrast images in the final report.
In most cases, no modifier is needed when billing CPT 72156 alone. However, if multiple imaging services are performed during the same encounter (e.g., 72148 + 72156), modifiers like -59 (Distinct Procedural Service) or -76 (Repeat Procedure by Same Provider) may apply. Always check payer-specific guidelines.
You must document the medical necessity for using contrast, the indication for spinal imaging, pre- and post-contrast images, and the radiologist’s interpretation. Inadequate documentation is a common reason for denied claims or payer audits related to this code.
As of 2025, Medicare reimbursement for CPT 72156 typically falls in the range of $400–$600, depending on geographic region, place of service, and provider status (facility vs. non-facility). Always verify with CMS or your local MAC for the latest rates.
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