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Wiki MRI Brain

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Kimberley

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Order states HA'S and syncope.

IMPRESSION: Normal brain parenchyma. Mild mucosal thickening in the maxially sinuses.

Would it be apprpriate to code 478019 or 784.0/780.2
 
Depending on what the provider states. Normally the results are not used for code placement in a clinical setting, (diagnosis of CT results are normally not available when the provider orders the testing unless the encounter is a follow up for reading of test results). The providers diagnosis documentation should be coded if seen in a clinical setting and the CT results should be used if you are coding just for the CT.
 
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Mri brain

I agree with Joe. I would use the 784.0/780.2. I think the sinus results may be incidental and could possibly cause a denial if that is the only code used. If you wanted to you could code the sinus results as a third diagnosis code, but I would probably just leave it off because the 784.0/780.2 should be sufficient for payment.
 
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