I am hoping someone may be able to help me understand something that has really been confusing me. As you may know there are new CCI edits for MRI/MRA’s and CT/CTA’s.

I thought you could never bill a CT and CTA together that are performed in the same session because CTA’s are CT’s that have been post processed to create 3d imaging so a CT would be include in a CTA. It was also stated in the June 2009 edition of CPT Assistant that these codes should never be billed together.

CPT Assistant…June 2009
“Note that it is never appropriate to report both 71260 and 71275 for the same service.”

Now, I am reading information that says you CAN bill CT’s and CTA’s during the same session. Does anyone know the reason for the change?

Medlearn April 26, 2010...
Is it appropriate to code CPT 71275, CTA chest with contrast and CPT 71260, CT thorax with contrast, when performed at the same session, when there are two separate reports? There are new CCI edits for CT and CTA performed on the same date, as well as for MRI/MRA. Is it appropriate to bill both codes, CT & CTA or MRI & MRA, adding modifier 59?
It would be appropriate if there is medical necessity to perform both studies and the physician's dictated report indicates why each study was performed and what information was gleaned from it that would benefit the referring physician in the patient's management. Within the CTA report ensure there is documentation to support post processing of images. If this is not said, the documentation may not support a CTA.

Also, we have always billed the MRI/ MRA together. We are still doing this when medical necessity supports both exams. An example of this would be dizziness or a stroke. Does anyone have any opinions on this?

Does anyone know if CMS has issued any ruling on this?