72148
RadiologyCMS status: AMagnetic resonance imaging of the lumbar spine without contrast material. CMS 2026 global wRVU 1.48, total RVU approximately 7.18, Medicare global allowable approximately $240. The first-line outpatient imaging for radiculopathy, mechanical low back pain after failed conservative care, and suspected disc disease.
Drop 72148 into a scenario to see how unit volume rolls up to annual wRVUs, gross collections, and bonus.
Open in calculator →When to use it
Use 72148 when the workup of low back pain or lumbar radiculopathy requires advanced imaging and contrast is not indicated. Standard indications: persistent radiculopathy after 6 weeks of conservative care, suspected disc herniation, spinal stenosis evaluation, post-laminectomy recurrence (without enhancing tissue suspicion), cauda equina screening (when concerning symptoms but no overt red flags). 72149 (with contrast) and 72158 (without and with) are reserved for suspected tumor, infection (discitis, osteomyelitis), or post-operative recurrence requiring contrast to distinguish enhancing scar from disc.
Documentation checklist
- ✓Order with indication. Most payers require documentation of failed conservative care (6+ weeks of conservative management) for non-urgent lumbar MRI, OR red flags (bowel/bladder dysfunction, saddle anesthesia, new motor deficit, fever, history of cancer or IV drug use).
- ✓MRI safety screen completed.
- ✓Interpretation report covering vertebral bodies, intervertebral discs at each level, spinal canal, neural foramina, conus, cauda equina, paraspinal soft tissues. Specific findings (disc bulge, protrusion, extrusion, sequestration, foraminal narrowing, central canal stenosis).
- ✓Comparison to prior imaging where available, especially for post-operative cases.
- ✓Setting modifier and signed report.
Common pitfalls
- !Ordering 72148 for acute mechanical low back pain without red flags or failed conservative care. Most commercial payers deny on medical-necessity grounds.
- !Performing 72148 instead of 72158 in a post-laminectomy patient with recurrent symptoms. Distinguishing recurrent disc from enhancing scar usually requires contrast.
- !Reading lumbar plus thoracic MRI on the same encounter and billing 72148 plus 72146 separately when a combined study would have been more clinically appropriate. Single-region MRIs are usually correctly billed separately, but document medical necessity for each region.
- !Missing red flag documentation when expedited imaging is performed. Cauda equina, bowel/bladder, fever, cancer history must be in the chart to bypass conservative-care prerequisites.
- !Confusing 72148 with 72157 (whole spine MRI). 72157 is rarely the right code; bill the individual region.
Payer notes
Medicare covers 72148 with appropriate indication. Commercial payers (UnitedHealthcare, Aetna, Anthem) routinely require prior authorization for outpatient lumbar MRI and require documentation of failed conservative care or red flags. Workers' comp claims have separate review processes. Some Medicare Advantage plans require physical therapy trial documentation; check plan-specific criteria.