Carolyn Posted Thu 20th of March, 2014 14:37:02 PM
Can these two cpt codes be unbundled when performed at the same session, with the same indication for both studies?
SuperCoder Answered Fri 21st of March, 2014 12:42:01 PM
I am sorry to say NO.
It is based on current CCI edits.
Carolyn Posted Mon 24th of March, 2014 10:38:03 AM
Even though one is looking at the vasculature (cardiovascular system)and the other the brain (neurological system) itself?
SuperCoder Answered Mon 24th of March, 2014 12:59:12 PM
Agree that 70544 is for vasculature in head. Both 70553 and 70544 are without contrast.
Angio of vasculature is part of angio of brain and hence the bundle.
However, if the physician attempts angio of part of brain and also does angio in another vascular tree (may be in a larger vessel), the two may be reported together with modifier.
Carolyn Posted Tue 25th of March, 2014 11:36:35 AM
We are not doing an angio of the brain, we are doing an MRI of the brain and an MRA of the head and even if its done with contrast billing cpt code 70545 it still bundles to 70553. I am not sure what you are trying to say, please clarify.
SuperCoder Answered Tue 25th of March, 2014 16:18:05 PM
Interesting question. Here's what I found:
Chapter IX of the CCI manual states: "magnetic resonance imaging (MRI) and magnetic resonance angiography (MRA) procedures for the same anatomic location may be reported together in limited circumstances. If a technical study is performed which is utilized to generate images for separate MRI and MRA reports, only one procedure, either the MRI or MRA, for the anatomic region may be reported. Both an MRI and MRA may be reported for the same anatomic region if they are performed at separate patient encounters or if two separate and distinct technical studies, one for the MRI and one for the MRA, are performed at the same patient encounter. The medical necessity for the latter situation is uncommon."
The ACR rephrases this as, "According to CCI edit guidelines, when a full and complete brain MRI is performed separate from a full and complete MRA examination (separate data set acquisition) it would be appropriate to report both the MRI and MRA codes, and a 59 modifier should be added to designate that separate and distinct studies were performed."