-
If this is your first visit, be sure to check out the FAQ & read the forum rules. To view all forums, post or create a new thread, you must be an AAPC Member. If you are a member and have already registered for member area and forum access, you can log in by clicking here. If you've forgotten your username or password use our password reminder tool. To start viewing messages, select the forum that you want to visit from the selection below.
MRI of the Brain/including IAC billing
- Thread starter Bemcg1957
- Start date
kevbshields
Guest
MRIs of IACs code to the 70540-70543 code set.
As for appending the -59 modifier, that would be dependent upon the payer, as some consider the two exams bundled.
As for appending the -59 modifier, that would be dependent upon the payer, as some consider the two exams bundled.
PatriciaCPC
Guru
- Messages
- 219
- Best answers
- 0
I came across the same issue recently. I resolved it by contacting the insurance and authorizing both studies. I made sure the radiologist read and reported both seperately, and billed for both. From what I unserstand as long as they are seperately reportable, they are payable. 
Re: MRI of the Brain/Including IAC Billing
This is a common problem I have because I bill for several radiologists practices. So I would agree that in order to get get paid (especially by Medicare) there must be 2 separate and distinct reports with different diagnosis.
However when it comes to using a modifier, you'll guess is as good as anyone's. At first I use to bill with modifier 59. After several appeals, I received a letter from PA Medicare stating to use modifier 76. When that was used, they still denied the claim.
If someone has any better suggestions, please help. tracross3@hotmail.com
This is a common problem I have because I bill for several radiologists practices. So I would agree that in order to get get paid (especially by Medicare) there must be 2 separate and distinct reports with different diagnosis.
However when it comes to using a modifier, you'll guess is as good as anyone's. At first I use to bill with modifier 59. After several appeals, I received a letter from PA Medicare stating to use modifier 76. When that was used, they still denied the claim.
If someone has any better suggestions, please help. tracross3@hotmail.com