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Thread: MRI of the Brain/including IAC billing

  1. #1

    Default MRI of the Brain/including IAC billing

    AAPC: Back to School
    Would like input on this coding situation. I believe that the IAC's are viewed with the brain MRI, but the doc's would like both the orbit/neck mri billed w/59modifier, and the brain mri billed???????

  2. #2
    Join Date
    Apr 2007
    Louisville, KY


    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.
    Kevin B. Shields, RHIT, CPCO, CCS, CPC, COC, CCS-P, CPC-P, CPC-I

  3. #3


    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.

  4. #4
    Join Date
    Apr 2007

    Default 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
    Tracy CPC, Mt. Laurel, NJ

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