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MR Spine & Pelvis for Multiple Myeloma (Whole Body)

Susan Posted Wed 14th of September, 2016 10:57:49 AM
Is anyone performing MR Spine and Pelvis for Multiple Myeloma (Whole Body) Imaging? These cases include but not limited to the following anatomy: cervical spine, thoracic spine, lumbar spine, sacrum coccyx, & pelvis. CPT-AMA does not have a defined code & recommends CPT 76498, Unlisted MR Procedure. It is also recommended by Coding Strategies – referenced by Clinical Examples in Radiology Spring 2009. I'm looking for a suggested fee for this unlisted MR procedure and direction on billed charge. Is anyone having success with insurance at this point? Any guidance is appreciated! Thank you, Susan
SuperCoder Answered Thu 15th of September, 2016 12:21:59 PM

A whole body diagnostic MR imaging is uncommon, and there is no CPT code accurately describing this procedure. Unlisted MR code 76498 should be reported when the study is medically necessary and performed. However if MR procedure of specific anatomical regions is performed with separate reports, then those specific anatomical regions should be coded separately, and unlisted code should not be used. 

In case if using the unlisted MR procedure code, then one should attach its report while submitting the claim. The specific payers will then decide the payment according to their specific rules and preferences. Hope this helps!! Thanks.  

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