Summary & Overview
CPT 72147: MRI Thoracic Spine With Contrast
CPT code 72147 represents an MRI of the thoracic spinal canal and its contents performed with intravenous contrast. This diagnostic imaging code is used to assess the thoracic spinal cord, nerve roots, epidural space, vertebral bodies, and adjacent soft tissues for conditions such as neoplasm, infection, inflammation, demyelinating disease, or postoperative complications. Nationally, MRI spine imaging is a high‑volume, high‑value diagnostic service that influences surgical planning, neurologic management, and longitudinal care for spinal disorders.
Key payers included in this analysis are Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise overview of clinical context for contrast‑enhanced thoracic spine MRI, typical sites of service, and the scope of payer coverage. The publication also outlines common modifiers and coding practice considerations, benchmarking language for utilization and reimbursement where available, and relevant policy updates affecting MRI utilization and prior authorization processes.
This resource is intended for clinical coders, radiology administrators, and payer relations teams seeking a clear, national summary of CPT code 72147 — its clinical purpose, operational settings, and the payers typically involved in coverage decisions. Data not available in the input is identified explicitly where applicable.
Billing Code Overview
CPT code 72147 describes a diagnostic magnetic resonance imaging (MRI) of the thoracic spinal canal and contents with contrast. The procedure involves cross‑sectional imaging of the thoracic spine using intravenous contrast to evaluate the spinal canal, spinal cord, nerve roots, and surrounding soft tissues.
Service type: Imaging — MRI with contrast (thoracic spine)
Typical site of service: Outpatient imaging center or hospital radiology department
Clinical & Coding Specifications
Clinical Context
A 54-year-old patient presents to the outpatient radiology clinic with progressive mid-back pain, sensory changes and intermittent lower-extremity weakness. The ordering spine specialist requests an MRI of the thoracic spine with intravenous contrast to evaluate for intradural or extradural lesions, suspected neoplasm, epidural abscess, postsurgical scar versus recurrent disc disease, or demyelinating disease. The clinical workflow includes pre-procedure screening for MRI safety and renal function, IV placement for gadolinium-based contrast, performance of a contrast-enhanced thoracic spine MRI protocol by the MRI technologist, image interpretation by a board-certified radiologist, and generation of a diagnostic report to the referring provider. Typical site of service is an outpatient hospital imaging center or freestanding outpatient radiology center; the study may also be performed in an inpatient setting when clinically indicated. The service type is diagnostic imaging (contrast-enhanced MRI of the thoracic spinal canal and contents).
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
26 | Professional component | When reporting only the radiologist's interpretation separate from facility technical component |
TC | Technical component |