MRI coding
Compliance Monitor, February 3, 2006
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Q: When performing an MRI brain with or without contrast and an MRI pituitary with or without contrast (physician order reads "MRI brain with or without contrast with special attention to the pituitary" is it appropriate to charge 70553 twice or should only one 70553 be charged? There may only be one diagnosis or two separate diagnoses.
A:According to the American College of Radiology, if both exams are ordered separately and a if a "full series of specialized pulse sequences specifically of the pituitary gland" are performed, code 70553 may be billed two times with the -59 modifier appended to the second line item. The ACR also goes on to state that "if just an additional pulse sequence or two" is performed for the pituitary, code 70553 should not be assigned a second time. The diagnosis may be the same or different for each code.
Thanks to Stacie Buck, RHIA, LHRM, Vice President Southeast Radiology Management in Stuart, FL.
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