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Criteria needed to bill codes together

Deaconess Posted Tue 03rd of July, 2018 10:36:07 AM
We need to know what criteria needs to be met when we bill a CT with CTA and then the same question for MRI with MRA. CT and CTA bundled services when is it appropriate to unbundle theses services. • 70450 and 70496 MRI and MRA bundled services, when is it appropriate to unbundle these service. • 70544 and 70551 • 70544 and 70553 • 70545 and 70553 One more while I am at it.
SuperCoder Answered Wed 04th of July, 2018 04:04:22 AM

Per NCCI edit guidelines, Computed tomography (CT) and computed tomographic angiography (CTA) procedures for the same anatomic location may be reported together in limited circumstances.

If a single technical study is performed which is utilized to generate images for separate CT and CTA reports, only one procedure, either the CT or CTA, for the anatomic region may be reported. Both a CT and CTA 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 CT and one for the CTA, are performed at the same patient encounter. The medical necessity for the latter situation is uncommon.

 

Note: Before you code a CT and CTA for the same date, be sure both tests:

• Have an order from the treating physician

• Are medically necessary

• Are documented separately and completely.

 

 

Similarly, magnetic resonance imaging (MRI) and magnetic resonance angiography (MRA) procedures for the same anatomic location may be reported together in limited circumstances.

If a single 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.

 

Note: In such case(s), you will also append the 59 (Distinct procedural service) modifier to designate that separate and distinct studies were performed. 

 

For more clarity, refer the below provided links:

https://www.supercoder.com/coding-newsletters/my-radiology-coding-alert/reader-question-think-twice-before-reporting-ctcta-article

https://www.supercoder.com/coding-newsletters/my-radiology-coding-alert/reader-question-earn-for-both-mri-and-mra-141513-article

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