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MRIs

Vicki Posted Thu 29th of September, 2016 20:05:49 PM
Can you bill separately for MRI of the Brian and MRI of the IACs if the referring doctors orders them separate with different DX? Also what about the MRI of the pituitary and brain studies? Will the payors reimburse for them separately?
SuperCoder Answered Fri 30th of September, 2016 06:14:34 AM

Greetings from SuperCoder!

 

The AMA says that you can report two brain MRIs (70551-70553) if you do scans of both the brain and the internal auditory canals (IACs). Snag: In order to code both studies, you need separate and distinct exams with separate and distinct indications. Just doing a few additional sequences of the IACs doesn't warrant coding an additional exam. And even if the exams meet the criteria for separate reporting, odds are the payer will deny the second service anyway.

 

Your second query regarding MRI of the pituitary and MRI of the brain studies is also the same. You should report MRI of the brain two times with a modifier (e.g. 59) to the second sequenced code. Please make sure that medical record should have documentation of separate indications for both the studies to be reimbursed.

 

Please feel free to write if you have any concern/query.

 

Thanks.

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