Summary & Overview
CPT 72142: MRI Cervical Spine With Contrast
CPT code 72142 represents an MRI of the cervical spinal canal and contents performed with contrast material, a commonly used diagnostic imaging study for evaluating cervical spinal cord pathology, nerve root compression, infection, inflammation, and neoplasm. Nationally, contrast-enhanced cervical spine MRI is important for differential diagnosis when non-contrast imaging is inconclusive or when enhancement patterns inform clinical decision-making.
Key payers covered in the analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise overview of billing and clinical context for CPT code 72142, including typical sites of service, common modifiers (listed separately), and how the procedure fits into imaging workflows. The publication outlines benchmark considerations, coding practice points, and policy-related updates that affect authorization and coverage for contrast-enhanced cervical spine MRI.
The content provides clinical context for when contrast-enhanced cervical spine MRI is used, summarizes common payer coverage patterns and authorization requirements at a national level, and highlights areas where billing practice and documentation impact claim adjudication. Data not available in the input is noted where applicable.
Billing Code Overview
CPT code 72142 describes a magnetic resonance imaging (MRI) study of the cervical spinal canal and contents performed with contrast material. This is a diagnostic imaging service focused on the cervical spine to evaluate the spinal canal, spinal cord, nerve roots, and surrounding soft tissues.
Service type: Diagnostic MRI with contrast of the cervical spine
Typical site of service: Hospital outpatient radiology department or independent outpatient imaging center
Clinical & Coding Specifications
Clinical Context
A 52-year-old patient with progressive neck pain, intermittent upper extremity radiculopathy, and new-onset gait instability is referred for diagnostic imaging. The ordering provider requests a contrast-enhanced MRI of the cervical spine to evaluate for cord compression, demyelinating lesions, neoplasm, infection, or post-surgical complications. The clinical workflow includes verification of MRI safety screening, assessment of renal function (e.g., estimated glomerular filtration rate) to determine contrast safety, obtaining informed consent for gadolinium-based contrast if required by facility policy, placement in the MRI scanner with appropriate cervical spine coil, acquisition of pre-contrast sequences, intravenous administration of gadolinium-based contrast, acquisition of post-contrast sequences, image reconstruction, and radiologist interpretation with a written report. Results are communicated to the referring provider, and images are archived in the PACS for clinical correlation and follow-up planning.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
26 | Professional component | When billing only the interpreting physician's professional service separate from technical imaging. |
TC | Technical component |