AAPC - Back to school
Results 1 to 3 of 3

Thread: cpt 70553 with a Modifier 22????

  1. #1

    Unhappy cpt 70553 with a Modifier 22????

    AAPC: Back to School
    Hello, Radiology Coding Experts. I really need your advice.

    Doc is coding MRI Brain w/attn to Pituitary Gland and wants to use a modifier 22 because he states it is an extra test. Also he dictates a separate paragraph with the Attn to the Pituitary Gland and his findings on that.

    This is a separate paragraph on the same report as the MRI Brain w and without.

    My question is this. Is there any circumstances where a Mod 22 wound be a valid modifier to add to ANY diagnostic test for separately identifiable procedure? And if so, what would be an example of that circumstance?

    If the answer is no, and the mri brain with and without contract (CPT 70553) covers the exam of the pituitary gland. where can I find documentation to that effect to inform the doctor???? pLEASE HELP!


    Claudia K

  2. #2


    Per the ACR, if MRI brain and MRI pituitary are separately ordered and performed w/a full series of sequences specifically of the pituitary gland, then MRI brain CPT should be reported two times w/a mod 59 on the second study. There needs to be "clear, separate, and distinct" indications for the two studies. However, very few 3rd party payors will reimburse for two MRIs of the brain during same encounter. Some providers have chosen to report a single MRI w/mod 22, but 22 can not be used on hospital outpatient claims.

    This information is from the 2003 AMA CPT Coding Symposium and is stated in the CSI Navigator for Diagnostic Radiology 2008 edition.

    Hope that helps!

  3. #3

    Question mri brain w cpt 70553 and mod 22

    Thanks for the info. One question: IF this is being performed at a free standing radiology facility, it is outpatient, right? Are you saying in that instance that you cannot append mod 22???


Similar Threads

  1. Modifier 59 for 70553 and 70544
    By Openmri1 in forum Diagnosis Coding
    Replies: 6
    Last Post: 03-11-2015, 10:43 AM
  2. Modifier 59 for 70553 and 70544
    By Openmri1 in forum Modifiers
    Replies: 3
    Last Post: 05-22-2014, 12:46 AM
  3. 70553 code please help
    By lisairwin in forum Interventional Radiology
    Replies: 2
    Last Post: 10-16-2012, 07:18 PM
  4. 70544 and 70553 unbundled???
    By Shay2025 in forum Medical Coding General Discussion
    Replies: 3
    Last Post: 01-09-2012, 01:01 PM
  5. HELP please!!! MRI of Brain 70553
    By denamfailla in forum Medical Coding General Discussion
    Replies: 0
    Last Post: 11-16-2010, 08:03 PM

Posting Permissions

  • You may not post new threads
  • You may not post replies
  • You may not post attachments
  • You may not edit your posts

Enjoying Our Forums?

AAPC forums are a benefit of membership. Joining AAPC grants you unlimited access, allowing you to post questions and participate with our community of over 150,000 professionals.

Join Now Continue Reading Without Full Access

Already a Member?


Close Message

In addition to full participation on AAPC forums, as a member you will be able to:

  • Access to the largest healthcare job database in the world.
  • Join over 150,000 members of the healthcare network in the world.
  • Be a part of an industry leading organization that drives the business side of healthcare.
  • Save anywhere from 10%-50% with exclusive member discounts on courses, books, study materials, and conferences.
  • Access to discounts at hundreds of restaurants, travel destinations, retail stores, and service providers. AAPC members also have opportunities to save on heath, life, and liability insurance.
  • Become a member of a local chapter and attend regular meetings.