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MRI-Mod LT/RT

  1. #1
    Default MRI-Mod LT/RT
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    Hello,

    CPT 72195 (MRI of Pelvis), I have a claim from a provider with 72195-LT, 72195-RT (right and left hip), wouldn't MRI of Pelvis include both LT/RT or is the way it billed correct?
    Marilyn CPC, CPC-H, CEMC

  2. #2
    Location
    Birmingham, Alabama
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    Default
    Quote Originally Posted by mmunoz21 View Post
    Hello,

    CPT 72195 (MRI of Pelvis), I have a claim from a provider with 72195-LT, 72195-RT (right and left hip), wouldn't MRI of Pelvis include both LT/RT or is the way it billed correct?

    I do not think it is billed correctly. There are not two pelvises (LT/RT) so the modifier does not apply. It should be billed only once.

    Perhaps they should have coded for extremities instead but that depends on the documentation.

    I hope this helps.
    Danny L. Peoples
    CIRCC,CPC

  3. Default
    Use 73721-LT and 73721-RT for Hip MRI if the procedure performed without contrast for with contrast use 73722 and for with and without contrast use 73723.


    Thanks,

    Vikas Maheshwari

    MBA-HCS, CPC-H

  4. #4
    Smile Hi!
    This is what we use to tell the difference:
    When you need to code for bilateral hip MRIs, don't be tempted to report an MRI of the pelvis (72195-72197, Magnetic resonance [e.g., proton] imaging, pelvis ...). The CPT codes for a pelvis MRI are not joint codes. When the order is for a hip MRI, only use the lower- extremity joint codes 73721-73723.

    Only use the MRI pelvis codes if the order is specifically for a pelvis MRI and/or the physician looks at the pelvic viscera, such as the organs and soft tissue.

    Hope it helps!!

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