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medicare rule on mri and mras

  1. #1
    Question medicare rule on mri and mras
    Medical Coding Books
    :Hello Radiology coders!

    I have been asked a confusing question. Can an MRI Brain, 70551-70553, MRA Brain (70544-70546) and a MRA Neck (cervical) (70547-70549) be billed to Medicare on the same date of service?

    I don't know of a specific rule regarding this for Medicare. If anyone can help shed light on this subject, I would greatly appreciate it.


  2. Default
    Have you thought about checking out the ACR website? Perhaps they could offer you some guidance.

    But I think you can bill for all three, but I would double check CCI edits and of course don't forget the payment rules such as the multiple procedure reduction payment policy and the DRA caps to payments.

  3. Default
    As long as you have an order for each exam and have met medical necessity for each exam, I don't know why you couldn't.

  4. #4
    I have not had any denials on tbilling all three. You cannot bill two MRI's of the brain or an MRA and a MRV on the same day. I hope this helps.

  5. #5
    My company has radiology centers in several states and we have no problem billing all 3 when necessary.

  6. #6
    Wink medicare rules on mri and mra billing
    Thank all of you so much for your help. I had never heard of such a rule either but wanted to verify that.
    You know as they say, power in numbers.
    ClaudiaK, CPC

  7. #7
    Default All 3
    You should put a 59 modifier on the 70544 when you bill.

  8. #8
    The 59 modifier msut be added to the 70544 for medicare.

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