# Dx code for orbit screenings



## ulmer

When coding for orbit screenings before mri's, should the dx code be v72.5, if no foreign object found, or should the code be the one that is for the reason the patient is being seen for the mri? We have conflicting answers for this. Thank you


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## jmcpolin

I worked for a Radiology practice for 7 years and we always used V82.89


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## mitchellde

Screening is for asymptomatic patients.  If the patient presents with a symptom, which needs investigatingthen it is not screening and you would use the symptoms.


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## jmcpolin

but you are not doing the screening for the symptom or sign that they are having the MRI they are doing a screening for possible metal fragments in the eyes, that may interfere with the MRI.


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## mitchellde

Still a symptomatic patient, use the symptoms.


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## jgf-CPC

Our patients are screened for metallic fragments normally from a past job that caused this possibility. There are never any signs or symptoms for this screening for foreign bodies so the physicians tell us to use V82.89 unless the foreign body is present. Hope this helps.


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## mitchellde

I still disagree there is a symptomatic reason for the MRI


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## RADCODER

I too have questioned this in the past and saved the response I received for reference. 

PER ACR CODING Q & A
http://www.acr.org/Hidden/Economics...hives/JulyAugust2005/Coding_qa.aspx?css=print

Q: Before performing an MR study, a plain film of the orbits is performed to detect any metallic foreign bodies that may be present which would cause eye damage to the patient during an MRI procedure. Is the performance of a plain film in this instance considered a scout film which is not reported or is it considered a screening diagnostic study and separately reportable?

It is the consensus of the American College of Radiology's Committee on Coding and Nomenclature that a plain film of the orbits (to detect a foreign body) which is performed prior to an MRI procedure is not considered a scout film. A scout film is an inherent part of an imaging study typically performed on the same modality.

The plain film or digital image on PACS is reported using CPT® code 70030 – Radiological examination, eye, for detection of foreign body. Orbit studies are ordered for patients prior to an MRI when medically necessary (i.e. history of sheet metal work, prior history of intraocular foreign body).

------------Like the Answer states, a plain film/digital image of the eye for FB (70030) is reported prior to an MRI when medically necessary, i.e. HX of sheet metal work. That DX code is *V82.89*. That is the ICD standard to be used if you have no other carrier specific direction.


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## jmcpolin

Thank you Jessica I thought it a bit strange to code the 70030 with lets say 724.2 low back pain.


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## jgf-CPC

Thanks for the confirmation Jessica. I knew we were on the right track!!!!


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## mitchellde

The article states:
Orbit studies are ordered for patients prior to an MRI *when medically necessary* (i.e. history of sheet metal work, prior history of intraocular foreign body).   
I will agree that hx of codes are appropriate.  The article does not state to use screening codes as the standard.  It says the studies are "when medically necessary"  therefore you need a dx code that suggests medical necessity, so a hx of code is appropriate.  I just feel there has to be some other more appropriate code other than an unspecified screening.  Maybe there is not but it does not feel right.


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## susiekay

I guess we have always used V71.89.  Right or wrong that's what we use!


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