When to use CPT code 74712 and 74713

Magnetic resonance imaging (MRI) is a radiation-free, noninvasive technique that produces high quality sectional images of the inside of the body in multiple planes. MRI uses the natural magnetic properties of the hydrogen atoms in our bodies that emit radiofrequency signals when exposed to radiowaves within a strong electromagnetic field. These signals are processed and converted by the computer into high-resolution, three-dimensional tomographic images. Patients with metallic or electronic implants or foreign bodies cannot be exposed to MRI. The patient must remain still while lying on a motorized table within the large, circular MRI tunnel. A sedative may be administered, as well as contrast material for image enhancement. These codes report examinations performed on the fetus, including placenta and maternal pelvis, when performed. CPT code 74712 is reported for a single or first gestation and CPT code 74713 for each additional gestation.

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Description of CPT code 74712 and 74713 in detail

74712 – Magnetic resonance imaging, fetal, including placenta and maternal pelvic imaging when performed; single or first gestation
+74713– Each Additional gestation (list separately in addition to primary code

Read also: Best coding tips for Pregnancy Complication ICD 10 codes

Do and Don’t for CPT code 74712 and 74213

Do not report CPT code 74712, 74713, in conjunction with 72195, 72196, 72197.
If only placenta or maternal pelvis is imagined without fetal imaging , use CPT codes 72195, 72196 or 72197. Report, 72195 if no contrast is used, 72196 if performed with contrast and 72197 if performed first without contrast and again following the injection of contrast.

Code 74712 should be reported for a single (or first) fetus imaged. Code 74713 describes the MRI of each additional fetus imaged. If fetal MRI is performed to image triplets, code 74712 is reported once, and code 74713 is reported with 2 units. If the intention of the MRI scan is to evaluate the placenta or maternal pelvis of a pregnant patient, rather than fetal imaging, codes 72195-72197 should be reported. Codes 72195-72197 may not be reported in conjunction with code 74712 or 74713. Exclusionary and reciprocal parenthetical notes were added following codes 72195-72197 to maintain consistency with the parenthetical notes added following codes 74712 and 74713.

Example of CPT code 74712

A 37-year-old, gravida 2, para 1 female who is at 23 weeks’ gestation presents with an unexpected finding of fetal central nervous system abnormality seen on obstetrical ultrasound. She is referred for MRI to further characterize the abnormality and assessed for additional fetal anomalies or syndromic features.

Example of CPT code 74713

A 32-year-old, gravida 0, para 0 female who is at 21 weeks’ gestation and pregnant with monochorionic-diamniotic twins, has ultrasound imaging findings suspicious for twin-to-twin transfusion syndrome. Fetal MRI is ordered as part of the work-up prior to intervention and to exclude other anomalies that may coexist with or mimic this syndrome. The first fetus has been imaged (reported separately) and now a second fetus is imaged. (This is an add-on code.)