For Members:
- What is MRI?
- Magnetic resonance imaging (MRI) is a radiation-free, non-invasive, technique that uses strong magnetic fields to produce high quality, detailed and sectional images of the inside of the body in multiple planes.
- The magnetic fields and radio waves used during MRI scan are not harmful. Multiple Researches has confirmed that MRI scans are one of the safest medical procedures available.
- An MRI scan is performed as an outpatient procedure; you are not required to stay in the hospital overnight.
- You will be provided earplugs or headphones to wear because inside the MRI scanner tube, it is bit noisy.
- It is a painless and safe procedure; anaesthesia or sedation is not needed usually.
- For post-operative scarring, or an infection or spinal tumor is suspected, contrast material is very likely to be used during the scan.
- For a patient who has already under gone the spinal surgery, contrast agent is helpful in differentiating a recurrent or remaining disc herniation from scar tissue.
- MRI scans aren’t usually recommended for pregnant women.
- At the initial onset of spine-related pain, it is not usually necessary to obtain an MRI scan because most cases of back pain will resolve within 2 to 12 weeks with proper conservative (non-surgical) treatment.
- If conservative treatment is not effective and more aggressive back pain treatments (e.g. injections or surgery) are contemplated to relieve the symptoms, then MRI scans are needed.
- What are the General Indications for MRI Lumbar Spine?
- Suspicious of Cancer or Metastases.
- Spinal Infection (Abscess, Arachnoiditis, Discitis, Osteomyelitis).
- Fracture or trauma.
- Cauda quine or Ankylosing spondylitis or radicular compression.
- Post-operative or post-procedure evaluation.
- What are the Specific Indications for MRI Lumbar Spine?
- The below symptoms require MRI regardless of the duration of the symptoms:
- Abnormal reflexes in the lower body (may indicate disruption of the nerves that enable sensation and movement).
- Foot Drop (inability to lift your foot).
- Dysfunction or loss of bowel and/or bladder control.
For Healthcare Providers:
- All MRI require pre-approval from Nextcare.
- Always submit detailed history of the sign & symptoms with onset and duration of the disease.
- For the majority of patients with acute low back pain, symptoms and/or physical exam findings will improve or resolve during a trial of conservative treatment and diagnostic imaging is not necessary.
- In case of trauma, kindly provide:
- Details of trauma (when, where and how).
- Neurological findings.
- If X-Ray is already done, please provide the report.
- In Case without trauma, kindly provide:
- Onset and duration of the condition.
- Conservative management done and for how long and how was the response.
- Complete physical examination and neurological findings.
- Signs and symptoms of severe radiculopathy or spinal stenosis.
- The CPT code assignment for an MRI procedure is based on the anatomic area being examined, kindly submit accurate CPT.
- Requests for multiple MRI imaging of the same anatomic area to address patient positional changes, additional sequences or equipment are not good medical practices. These variations or extra sequences are included within the original imaging request.
- Avoid submitting additional/multiple unnecessary CPTs.
| CPT |
Description |
| 72148 |
Magnetic resonance (e.g., proton) imaging (MRI), spinal canal and contents, lumbar; without contrast material |
| 72149 |
MRI spinal canal and contents, lumbar; with contrast material. |
| 72158 |
Magnetic resonance (e.g., proton) imaging (MRI), spinal canal and contents, without contrast material, followed by contrast material(s) and further sequences; lumbar |
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