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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
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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