Wiki What would you code this report? ABDOMINAL AORTA AND BILATERAL ILIAC MRA

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Our physicians bill PC only. 74185 was billed on the below; however, insurance has denied. Can someone tell me if this is correct or not? Thank you in advance!

---FINAL REPORT ----------------
ABDOMINAL AORTA AND BILATERAL ILIAC MRA (30 mL ProHance):

TECHNIQUE: Axial, sagittal, and coronal images with reformatted images of the vessels.

FINDINGS: Abdominal aortic aneurysm normal contour and caliber; widest diameter is approximately 18 mm. Normal contour and caliber bilateral common iliacs, bilateral external iliacs, and bilateral internal iliacs. The common femoral arteries are not visualized beyond the inferior margin of the study, could be artifactual, however, occlusions with reconstitution of the distal profunda femoral arteries are suspected. If further evaluation is required, recommend followup bilateral lower extremity arterial MRA or CT angiogram of the common femoral arteries for better visualization.

Celiac axis and superior mesenteric artery widely patent. Minimally visualized portions of the liver, spleen, and kidneys are grossly unremarkable. No retroperitoneal adenopathy. Moderate motion artifact within the bowel obscures detail. Uterus retroverted to the left.

IMPRESSION: NORMAL ABDOMINAL AORTA AND BILATERAL COMMON ILIAC, EXTERNAL ILIAC, AND INTERNAL ILIAC MRA. PLEASE NOTE THE COMMON FEMORAL ARTERIES ARE NOT VISUALIZED BILATERALLY, MAY BE ARTIFACTUAL, HOWEVER, OCCLUSIONS CANNOT BE EXCLUDED. RECOMMEND FOLLOWUP BILATERAL LOWER EXTREMITY MRA OR CT ANGIOGRAM FOR FURTHER EVALUATION.

Results discussed with Dr. x February 28, 2014, at 0930 hours, and results were discussed with the patient via phone conversation on her cell phone, 606-219-2004, at 0945 hours. The patient stated that she was leaving the state and was not going to return for several months' time and was feeling fine and that in her opinion her circulation in her lower extremities was good without complaints, and she is not interested in pursuing a further study at this time.

End report.
 
Our physicians bill PC only. 74185 was billed on the below; however, insurance has denied. Can someone tell me if this is correct or not? Thank you in advance!

---FINAL REPORT ----------------
ABDOMINAL AORTA AND BILATERAL ILIAC MRA (30 mL ProHance):

TECHNIQUE: Axial, sagittal, and coronal images with reformatted images of the vessels.

FINDINGS: Abdominal aortic aneurysm normal contour and caliber; widest diameter is approximately 18 mm. Normal contour and caliber bilateral common iliacs, bilateral external iliacs, and bilateral internal iliacs. The common femoral arteries are not visualized beyond the inferior margin of the study, could be artifactual, however, occlusions with reconstitution of the distal profunda femoral arteries are suspected. If further evaluation is required, recommend followup bilateral lower extremity arterial MRA or CT angiogram of the common femoral arteries for better visualization.

Celiac axis and superior mesenteric artery widely patent. Minimally visualized portions of the liver, spleen, and kidneys are grossly unremarkable. No retroperitoneal adenopathy. Moderate motion artifact within the bowel obscures detail. Uterus retroverted to the left.

IMPRESSION: NORMAL ABDOMINAL AORTA AND BILATERAL COMMON ILIAC, EXTERNAL ILIAC, AND INTERNAL ILIAC MRA. PLEASE NOTE THE COMMON FEMORAL ARTERIES ARE NOT VISUALIZED BILATERALLY, MAY BE ARTIFACTUAL, HOWEVER, OCCLUSIONS CANNOT BE EXCLUDED. RECOMMEND FOLLOWUP BILATERAL LOWER EXTREMITY MRA OR CT ANGIOGRAM FOR FURTHER EVALUATION.

Results discussed with Dr. x February 28, 2014, at 0930 hours, and results were discussed with the patient via phone conversation on her cell phone, 606-219-2004, at 0945 hours. The patient stated that she was leaving the state and was not going to return for several months' time and was feeling fine and that in her opinion her circulation in her lower extremities was good without complaints, and she is not interested in pursuing a further study at this time.

End report.

For that code, there has to be documentation the the test was done with and without contrast. As is, I see a MRA of the abdomen with contrast. Have the doctor amend his dictation to say with/without if that was performed.

Thanks,
Jim Pawloski, CIRCC
 
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