CPT code 71552 – MRI chest without and with contrast

Key takeaways

CPT code 71552 reports a chest MRI acquired without contrast, then with contrast and further sequences, in one session.

Breast MRI is billed with 77046 to 77049, so a breast study never goes on a 71552 claim.

Bill 71552 alone when both sequence sets run. Never report 71550 or 71551 alongside it for the same session.

The 2026 national Medicare non-facility rate for the global 71552 is about $466, from 13.95 total RVUs.

Chest MRI has no laterality, so LT, RT and modifier 50 have no place on a 71552 claim.

CPT code 71552 is a chest MRI without, then with, contrast

CPT code 71552 reports one chest MRI session in which images are acquired without contrast, then again after contrast with further sequences. The American Medical Association (AMA) publishes the official descriptor, quoted in full in the table below. It sits in the Chest subsection of Diagnostic Radiology, which runs from 71045 to 71555.

So the code always carries two sets of images of the thorax. The first set is acquired before any gadolinium goes in. The second set follows the injection, along with any further sequences the protocol calls for.

What 71552 covers, and when radiologists order it

71552 covers the whole chest: the mediastinum, the hilar regions, the pleura, the chest wall and nearby soft tissue. Radiologists choose the combined protocol when the clinical question turns on how tissue enhances.

Comparing the pre-contrast and post-contrast images shows whether a mass or node takes up gadolinium. That helps separate solid tumor from cyst, fluid or fibrosis. Orders billed under 71552 commonly document these indications:

• Hilar or mediastinal lymphadenopathy that CT could not characterize, as the AMA descriptor itself suggests
• Anterior mediastinal masses, including suspected thymoma or thymic cyst
• Superior sulcus (Pancoast) tumor evaluation before surgery or radiation planning
• Chest wall or pleural disease, including suspected mesothelioma
• Staging of a known lung cancer where local invasion of the mediastinum or chest wall is in question
• Suspected sarcoidosis or lymphoma with hilar node involvement

Three nearby studies are not 71552, even though they image structures inside the chest. Breast MRI has its own codes, 77046 to 77049. Cardiac MRI uses 75557 to 75565, and magnetic resonance angiography of the chest is 71555.

71550 vs 71551 vs 71552: Contrast decides the code

All three chest MRI codes share the same region and modality. They differ only on contrast. The 2026 CMS relative value units (RVUs) climb with each step, which is why the right choice matters to payment.

Under CMS National Correct Coding Initiative (NCCI) edits, 71550 and 71551 are not reported with 71552 for the same session. 71552 already describes the combined study, so adding either one is unbundling.

The non-contrast version of this study has its own guide. CPT code 71550 covers the documentation and denial patterns when no gadolinium is used.

Documentation that supports a 71552 claim

A payer reviewer should be able to trace every 71552 claim from the clinical question to both image sets. Most downcodes on this code start with a report that names contrast but not the pre-contrast images. A clean claim checklist catches that before submission. The chart below maps each documented image set to the one code it supports.

• Both sequence sets documented: The signed report must state that images were acquired before contrast and again after it. If it only describes post-contrast images, the supportable code is 71551.
• Contrast details recorded: Note the agent, dose and route. That record also supports any separate contrast supply line your payer allows.
• Clinical indication: State the specific question, such as “characterize anterior mediastinal mass seen on CT.” A generic “chest imaging” order invites a medical necessity denial.
• Why MRI over CT: Many payers expect a CT first. The order should explain why CT fell short or is contraindicated.
• Ordering provider NPI: Medicare requires the ordering physician’s NPI on the claim, and most commercial payers follow suit.
• Signed final report: The interpreting radiologist must sign the final report. A preliminary read cannot support billing.
• Prior authorization number: If the payer required one, enter it in item 23 of the CMS-1500 or the matching 837P field.

Which ICD-10 codes support medical necessity for 71552?

Every 71552 claim needs a diagnosis from the ICD-10-CM codes that matches the order and the report. Choose the most specific code the documentation supports. The table lists common pairings for chest MRI.

Use a symptom or finding code such as R59.0 or R91.8 only until a definitive diagnosis is documented. Coverage criteria vary by Medicare Administrative Contractor (MAC), so check the CMS Medicare Coverage Database before you submit.

Prior authorization: Get it for the right code

Most commercial payers and many Medicaid managed-care plans require prior authorization for chest MRI. Build the check into insurance eligibility verification before the scan is booked.

• Authorize the code you will bill: An authorization for 71550 or 71551 does not always cover 71552. If the protocol may add contrast, request 71552 or ask the payer how it handles a change on the day.
• Traditional Medicare: Medicare Part B does not require prior authorization for outpatient diagnostic MRI. Medicare Advantage plans set their own rules.
• Radiology benefit managers: Many commercial plans route imaging requests to a benefit manager. Expect to supply the indication, prior CT results and the reason for contrast.
• Supporting records: Send the ordering notes, prior imaging reports and any specialist letters that explain why MRI is needed over CT.

Retro-authorization requests are often refused, so the request should leave with the order. A written prior authorization process keeps it off the scan-day to-do list. Clinical reviewers often cite the ACR Appropriateness Criteria when they assess an imaging request.

Medicare pays about $466 for 71552 in 2026

Medicare pays 71552 under the 2026 Medicare Physician Fee Schedule (MPFS). The figures below come from the CMS 2026 national relative value file, multiplied by the $33.4009 conversion factor.

These are national amounts before Geographic Practice Cost Index (GPCI) adjustment, so your local rate will differ. Qualifying APM participants use a slightly higher conversion factor of $33.5675.

In a hospital outpatient setting, the radiologist bills 71552-26 under the MPFS. The hospital’s technical payment comes through the Outpatient Prospective Payment System instead, so the global and TC amounts above don’t apply there.

CMS also flags 71552 for the diagnostic imaging multiple procedure payment reduction. When several advanced imaging studies happen in one session, later studies are paid at a reduced rate. Check your locality in the CMS Physician Fee Schedule lookup tool before you project revenue.

Modifiers that split or adjust a 71552 claim

Modifiers tell the payer who did which part of the study, or that something changed during it. On 71552 the component split is by far the most common case.

Laterality modifiers have no role here. The chest is imaged as one region, and CMS gives 71552 a bilateral indicator of 0. LT, RT and modifier 50 don’t apply.

A provider who bills the global code should not also bill TC or 26 for the same study. That pays the same work twice and invites an audit.

Why 71552 claims get denied, and how to fix each one

71552 claims fail for a predictable set of reasons, and most can be fixed before submission. A structured denial management workflow stops the same error from repeating.

If your team bills breast MRI as well, keep the two code sets apart in your charge master. CPT code 77049 covers bilateral breast MRI without and with contrast.

Before you submit: A six-point 71552 checklist

Run these checks at the coding step, while a fix still takes minutes rather than an appeal.

• The signed report names both the pre-contrast and the post-contrast images.
• The study is of the chest, not the breast or the heart.
• The order explains why MRI was chosen over CT, or why CT fell short.
• The ICD-10-CM code is active for the date of service and matches the report.
• The authorization, if required, was issued for 71552.
• TC or 26 is appended when only one component is billed, and never alongside the global code.

How Pabau keeps the chest MRI order, forms and invoice together

Many imaging practices keep the order in one system, the safety questionnaire on paper and the invoice in another. When a payer queries a 71552 claim, staff hunt across all three for the indication and the signed forms.

Pabau, the all-in-one practice management system we build, keeps them on one patient record. MRI safety and contrast screening questionnaires go out as digital forms before the appointment. The answers land on the patient’s file, next to the appointment and the treatment notes.

Coding decisions stay with your coders. With Pabau’s medical billing software, the claim is then submitted, tracked and reconciled from that same record. When a payer asks for the order, the screening forms or the payment, they sit in one place.

Keep every chest MRI record in one place

Pabau holds the order, screening forms, notes and invoice on one patient record. Your team answers a payer query without searching three systems.

Book a demo

Conclusion

Treat the signed radiology report as the deciding document for 71552. If it names both image sets and the order explains why MRI beat CT, the code defends itself on review.

The costlier mistakes happen before coding starts. A breast study coded as a chest MRI, or an authorization issued for the wrong contrast code, turns into weeks of appeals. A question to the radiologist or the payer before submission costs minutes.

Pabau keeps the order, screening forms and invoice for each scan on one patient record. Book a demo to see how it fits your imaging practice’s workflow.

Continue your research

Billing a chest MRI with no contrast? CPT 71550 covers the non-contrast study and the denials that follow when contrast status is unclear.

Coding a breast MRI instead? CPT 77049 explains bilateral breast MRI without and with contrast, and how it differs from 77048.

Getting denials you can’t decode? Denial codes in medical billing covers the most common CARC reason codes and how to respond to each one.

Want to see how clearinghouse submission works end to end? Medical claims clearinghouse guide explains the 837P transaction flow and how claims are checked before payer adjudication.

Reconciling an imaging payment? Electronic remittance advice (ERA) explains how to read 835 files and post payment adjustments.

Frequently asked questions