Wiki medicare rule on mri and mras

[claudiak]

:Hello Radiology coders!

Help!
I have been asked a confusing question. Can an MRI Brain, 70551-70553, MRA Brain (70544-70546) and a MRA Neck (cervical) (70547-70549) be billed to Medicare on the same date of service?

I don't know of a specific rule regarding this for Medicare. If anyone can help shed light on this subject, I would greatly appreciate it.

Thanks
ClaudiaK,CPC

 

[Verve and bourb]

Have you thought about checking out the ACR website? Perhaps they could offer you some guidance.

But I think you can bill for all three, but I would double check CCI edits and of course don't forget the payment rules such as the multiple procedure reduction payment policy and the DRA caps to payments.

 

[lbahnson]

As long as you have an order for each exam and have met medical necessity for each exam, I don't know why you couldn't.

 

[screed@urhcs.org]

I have not had any denials on tbilling all three. You cannot bill two MRI's of the brain or an MRA and a MRV on the same day. I hope this helps.

 

[Radcoder1313]

My company has radiology centers in several states and we have no problem billing all 3 when necessary.

 

[claudiak]

medicare rules on mri and mra billing

Thank all of you so much for your help. I had never heard of such a rule either but wanted to verify that.
You know as they say, power in numbers.
Thanks
ClaudiaK, CPC
Networker

 

[sueolson]

All 3

You should put a 59 modifier on the 70544 when you bill.

 

[jgf-CPC]

The 59 modifier msut be added to the 70544 for medicare.