Wiki TC Modifier Coding/Billing

MeganJ90

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Hi there!

As coders we have run into a situation with MRI coding and billing that has stumped us. I am very eager for insight in this area if at all possible...

In the event that a patient comes in for an MRI say for example a 73722 Magnetic resonance (eg, proton) imaging, any joint of lower extremity; with contrast material(s), the patient is seen by the provider initially for an injection(gadavist) and then sent to the MRI. Is it appropriate to bill the injection for gadavist separately from the MRI? and to bill the MRI with a TC modifier? The MRI machine is owned by the practice and not a separate entity.
This is currently being submitted with the following codes;

73722-TC
27093
A9585(gadavist)
73525-26
76942-26

Please tell me your thoughts as I am flagging that the "contrast" gadavist appears to be being billed twice as the MRI code includes contrast? How do you suggest these be billed appropriately and what is the correct understanding of the TC modifier usage?

Thank you for your input!
 
Pam are you saying that it is appropriate to bill for the 73722-TC as well as the 27093, A9585, and 76492-26? I just need a little further insight before I report back to my practice.

Thank you!

Megan Jennison, CPC
 
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