Health Information Management

Q&A: Coding for an x-ray prior to an MRI

JustCoding News: Outpatient, May 19, 2010

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QUESTION: Which code should I report when a patient comes in to get an x-ray to check for a metallic foreign body prior to an MRI? Would I report an observation code?

ANSWER: I would suggest reporting ICD-9-CM code V72.5 (special investigations and examinations, radiological examination, not elsewhere classified) to substantiate the medical necessity for the x-ray.

You will also need to report the CPT radiological examination code appropriate for the anatomical site that the provider is screening. Without additional details about the x-ray, I cannot suggest a specific CPT code.

Your question does not include information about any observation services, so I don’t know how the situation could support an observation code.

In addition, if the patient came in just for the x-ray, there is no applicable evaluation and management code.

Editor’s note: Shelley C. Safian, MAOM/HSM, CCS-P, CPC-H, CHA, of Safian Communications Services in Orlando, FL, answered this question. She is a senior assistant professor who teaches medical billing and insurance coding at Herzing University Online in Milwaukee, WI. E-mail her at ssafian@embarqmail.com.

This answer was provided based on limited information submitted to JustCoding.com. Be sure to review all documentation specific to your own individual scenario before determining appropriate code assignment.



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