To evaluate musculoskeletal (MSK) radiologist whole-body magnetic resonance imaging (WBMRI) practice patterns in an effort to better understand current MSK clinical utilization and the need for standardized coding.
A 12-question survey was created in Survey Monkey®. The survey was e-mailed to Society of Skeletal Radiology (SSR) members on September 19, 2018. The survey included questions on SSR member demographics and on their experience with WBMRI.
One hundred sixty-four of 1454 (11%) SSR members responded to the survey. A minority (32%; n = 52/164) of respondents reported that their institutions routinely perform WBMRI. The most common indication was multiple myeloma (78%, n = 51/65). The most commonly utilized sequences were coronal short tau inversion recovery (STIR) (79%, n = 52/66) and coronal T1 without fat saturation (73%, n = 48/66). A large proportion of respondents (48%, n = 31/64) did not know the code used for billing WBMRI at their institutions. Of the remaining respondents, 23% (n = 15/64) reported use of the bone marrow MRI code, 16% (n = 10/64) the chest/abdomen/pelvis combination code, and 9% (n = 6/64) the unlisted MRI procedure code.
There is variation in who is responsible for the protocol and interpretation of WBMRI, as well as how the exam is performed and how the exam is coded, which raise barriers to broad implementation. Recent WBMRI guidelines for multiple myeloma and prostate cancer can mitigate many of these barriers, but they do not address the coding and reimbursement challenges. Collaborative multi-society development of a new CPT® code for WBMRI may be a worthwhile endeavor.