Summary & Overview
CPT 25246: Wrist Arthrography Contrast Injection
Headline: CPT code 25246 defines wrist arthrography contrast injection — a targeted diagnostic procedure for assessing intra-articular wrist pathology.
Lead: CPT code 25246 represents the percutaneous injection of contrast into the wrist joint to facilitate arthrography, an imaging technique that enhances visualization of cartilage, ligaments, and bony surfaces to diagnose tears, degenerative changes, and unexplained pain. This procedure plays a central role in the diagnostic pathway for complex wrist conditions and can inform both conservative and surgical management.
Why it matters: Nationally, accurate use and documentation of CPT code 25246 affect imaging utilization patterns, reimbursement flows to radiology and orthopedic practices, and the diagnostic workup for wrist pathology. Appropriate coding ensures clinical clarity and supports claims processing across public and private payers.
Payers covered: Analysis typically includes major national payers: Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare.
What readers will learn: This publication provides benchmarks for utilization and reimbursement where available, clarifies the clinical context and typical sites of service for CPT code 25246, and summarizes coding considerations and common modifiers (list provided). It also outlines implications for imaging workflows and documentation practices. Data not available in the input will be noted where applicable.
Billing Code Overview
CPT code 25246 describes the injection of contrast dye into the wrist for arthrography, an imaging study used to evaluate internal joint structures such as cartilage, ligaments, and bone and to help diagnose joint conditions and unexplained wrist pain.
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Service type: Image-guided diagnostic arthrography procedure
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Typical site of service: Outpatient radiology or ambulatory surgical center; may also be performed in hospital outpatient imaging departments depending on clinical setting
Clinical & Coding Specifications
Clinical Context
A 46-year-old patient presents to the outpatient radiology department with persistent dorsal wrist pain and intermittent mechanical locking after a fall six weeks prior. Physical exam demonstrates focal wrist joint tenderness and limited range of motion suggesting intra-articular injury. The orthopedic surgeon orders a wrist arthrogram to evaluate internal joint structures for suspected triangular fibrocartilage complex (TFCC) tear, occult intra-articular fracture, or radiographically occult cartilage or ligament injury prior to MRI or wrist arthroscopy.
The clinical workflow: the patient is consented and screened for contrast allergy and anticoagulation. The procedure is performed in a radiology procedure room or fluoroscopy suite. Using sterile technique, the provider localizes the wrist joint under fluoroscopy, anesthetizes the entry site, and injects iodinated contrast into the radiocarpal (and if indicated midcarpal or distal radioulnar) joint space. Fluoroscopic images are obtained to document contrast distribution and to detect intra-articular pathology. Contrast injection may be performed immediately prior to MRI when MR arthrography is planned. Post-procedure monitoring is brief and discharge instructions are provided.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
26 | Professional component | Use when billing only the interpreting physician's professional component separate from technical imaging services. |