CPT 72146 Thoracic Spine MRI Reimbursement | OpenPayer

Summary & Overview

CPT 72146: Thoracic Spine MRI, Without Contrast

CPT code 72146 identifies a non-contrast magnetic resonance imaging (MRI) study of the thoracic spinal canal and its contents. This diagnostic procedure is widely used to assess thoracic spinal cord pathology, compressive lesions, degenerative disease, traumatic injury, and neoplastic or infectious processes. As a high-resolution, non-invasive imaging modality, MRI of the thoracic spine is a core component of national diagnostic pathways for back pain, myelopathy, radiculopathy, and suspected spinal cord disease.

Key payers covered in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. The publication outlines payer coverage patterns, typical site-of-service settings, and coding considerations relevant to hospital outpatient departments and freestanding imaging centers.

Readers will find concise benchmarks for utilization and billing practices, summary-level policy context affecting coverage and prior authorization trends, and clinical context that informs appropriate use of thoracic spine MRI without contrast. The content is intended to support billing, compliance, and administrative stakeholders in understanding how CPT code 72146 fits into diagnostic imaging workflows and payer policies nationally. Data not available in the input for certain fields is noted where applicable.

AetnaBlue Cross Blue ShieldCigna HealthUnitedHealthcareMedicareCPT 72146thoracic spine MRIdiagnostic imagingradiologyspinal cord imagingoutpatient imagingnon-contrast MRI

Billing Code Overview

CPT code 72146 describes magnetic resonance imaging (MRI) of the thoracic spinal canal and contents without contrast. This diagnostic imaging service captures detailed cross-sectional images of the thoracic spine to evaluate the spinal cord, nerve roots, vertebral bodies, intervertebral discs, and surrounding soft tissues.

Service type: Diagnostic MRI, non-contrast
Typical site of service: Outpatient imaging center or hospital outpatient department

Clinical & Coding Specifications

Clinical Context

A middle-aged patient presents to the outpatient imaging center with progressive mid-back pain, intermittent thoracic radicular symptoms and numbness in the lower extremities. The referring neurosurgeon orders magnetic resonance imaging of the thoracic spine without contrast (72146) to evaluate suspected thoracic disc herniation, spinal stenosis, or intrinsic cord pathology. The clinical workflow: triage and verification of patient identity and contraindications (implants, pacemakers), screening for claustrophobia and renal function is not required for noncontrast studies, obtain informed consent for MRI safety, position the patient supine in the scanner, perform noncontrast thoracic spine sequences including sagittal T1, T2, STIR and axial T2 through levels of interest, technologist documents sequences and any complications, radiologist interprets images and generates report, and the ordering provider receives results for management decisions such as surgical consultation or conservative therapy. Typical site of service is an outpatient imaging center, hospital outpatient radiology department, or ambulatory surgery center when bundled with other procedures.

Coding Specifications

Modifier	Description	When to Use
`26`	Professional component	Use when billing only the physician interpretation separate from technical component.

CPT 72125: CT Cervical Spine Without Contrast

CPT-72197-MRI-PELVIS-WITH-AND-WITHOUT-CONTRAST

CPT 72197: MRI of Pelvis Without and With Contrast

CPT-72110-LUMBOSACRAL-SPINE-XRAY-MULTIPLE-VIEWS

CPT 72110: Lumbosacral Spine X‑Ray, Four or More Views

CPT-72265-LUMBAR-SACRAL-MYELOGRAM-IMAGING-INTERPRETATION

CPT 72265: Lumbar and Sacral Myelogram Imaging Supervision and Interpretation

CPT-72020-SINGLE-VIEW-SPINE-RADIOGRAPH

CPT 72020: Single-View Radiograph of Specific Spine Level

CPT-72285-DISCOGRAM-IMAGING-SUPERVISION-INTERPRETATION

CPT 72285: Imaging Supervision and Interpretation for Discogram

CPT-72129-THORACIC-SPINE-CT-WITH-CONTRAST

CPT 72129: CT Thoracic Spine with Contrast

CPT-72202-SACROILIAC-JOINT-XRAY-THREE-OR-MORE-VIEWS

CPT 72202: Sacroiliac Joint X‑ray, Three or More Views

CPT-72190-PELVIC-RADIOGRAPHY-THREE-VIEWS

CPT 72190: Pelvic Radiography, Minimum Three Views

CPT-72156-MRI-CERVICAL-SPINE-WITH-AND-WITHOUT-CONTRAST

CPT 72156: MRI Cervical Spine Without and With Contrast

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Taxonomy Code	Specialty	Notes
`2084P0800X`	Diagnostic Radiology	Most common specialty performing MRI acquisition and interpretation.
`2085R0201X`	Neuroradiology	Subspecialists who frequently interpret spine MRIs for complex pathology.
`207RG0100X`	Orthopedic Surgery	Referring specialty for degenerative spine disease and preoperative planning.
`2086S0105X`	Neurological Surgery	Referring and interpretive involvement for surgical decision-making.
`207L00000X`	Pain Medicine	Refers for imaging in interventional pain management planning.

Related Diagnoses

ICD-10 Code	Description	Clinical Relevance
`M51.06`	Thoracic disc disorder with radiculopathy	Indication for thoracic MRI to evaluate disc herniation compressing nerve roots.
`M48.04`	Spinal stenosis, thoracic region	MRI assesses degree of central or foraminal stenosis.
`G95.2`	Nontraumatic compressive myelopathy	Used when cord compression is suspected and MRI evaluates cord signal and compression.
`M54.6`	Pain in thoracic spine	Common presenting complaint leading to imaging when persistent or progressive.
`G83.4`	Cauda equina syndrome (not thoracic but included for completeness)	Data not available in the input.
`M51.05`	Thoracic disc disorder with myelopathy	Used when disc pathology causes spinal cord dysfunction requiring MRI evaluation.
`M48.05`	Collapsed vertebra, thoracic region	MRI to evaluate vertebral body collapse and associated spinal cord involvement.

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`72148`	Magnetic resonance imaging, spine, thoracic; with contrast material(s)	Performed when IV contrast is required to evaluate enhancing lesions or infection after initial noncontrast `72146`.
`72141`	Magnetic resonance imaging, cervical spine, without contrast material(s)	May be ordered concurrently when multiregional spine assessment is needed; performed separately from thoracic study.
`72156`	Magnetic resonance imaging, lumbar spine, without contrast material(s)	Often performed alongside thoracic MRI for symptoms spanning thoracic and lumbar regions.
`70553`	Magnetic resonance imaging, brain (including brainstem); without contrast material(s)	Ordered when thoracic cord signal abnormality raises concern for CNS processes requiring brain imaging.
`73221`	Magnetic resonance imaging, upper extremity; without contrast material(s), complete	Used when radicular symptoms extend into the upper extremity and a peripheral study is indicated.

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