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rectal fistula

TIFFANY Posted Tue 15th of January, 2019 17:13:57 PM
I am having trouble finding a CPT code for MRI fistulogram. Need to rule out fistula in the GI tract.
SuperCoder Answered Wed 16th of January, 2019 02:56:40 AM

Hi Christine,

 

There is no appropriate CPT code for MRI fistulogram. Please use unlisted CPT code 76498 (Unlisted magnetic resonance procedure (e.g., diagnostic, interventional) for MRI of anorectal fistula.

 

When submitting an unlisted-procedure code, your documentation should also include an explanatory cover letter. An insurer will decide to pay an unlisted-procedure claim by comparing your procedure description to a similar, listed procedure with an established reimbursement value.

 

Thanks!

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