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Radiology Coding Alert

You Be the Coder:
Use Same Code for MRVand MRA

Test your coding knowledge. Determine how you would code this situation before looking at the box below for the answer.   Question: Because CPT Codes does not designate a specific code for magnetic resonance venography (MRV) of the head, we use the magnetic resonance angiography (MRA) codes (70544-70546) for these services. When we perform both an MRA and MRV of the head on the same day, however, should we append modifier -22 (Unusual procedural services) to the MRV code? North Carolina Subscriber  
            Answer: You should report only one unit of the appropriate MRAcode (70544-70546). The September 2001 CPT Assistant offered the following example for 70545: "... An MR angiogram through the region of her arteriovenous malformation is obtained using 3D time-of-flight (TOF) following intravenous administration of contrast material "

Because CPTAssistant references the "arteri-ovenous" area, most carriers interpret the code as describing both arteries and veins. Therefore, payers will reimburse for only one unit of the MRAcode, even if you perform an MRV as well.