# Stereotactic surgery and MR billing



## jmehalich (Apr 18, 2008)

Hello all, I have a dilemma relate to the billing of MRI from the facility related to 61793- Stereotactic radiosurgery PFX Gamma Knife

Examination performed: MR stereo with contrast

Technique: Axial 3-D spoiled gradient post contrast images obtained through the brain with patient in the stereotactic head frame. Exam was performed following the intravenous administration of 17cc of MultiHance without reported adverse reaction in radiology assessment. 

What CPT code(s) should be used for the MRI usage from the facility? 
What code is used for the contrast?  
Does the facility get to bill for placement of the headframe each time? 
Does the faility also bill for the sterotactic service, if yes what code? 
Is there different code for which of MRI/CT these the facility uses, particle beam, gamma knife OR PFX gamma knife or linear accelerator? 

Seperate of course from the usual REV code supplies...what are all the codes the facility should bill? 

THANK YOU TO THE EXPERTS! Jackie Mehalich


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## kevbshields (Apr 19, 2008)

20660 looks like it's bundled in CCI with 61793, and is an SI of "C".  It would seem the facility could use it, but not with that "C" status in the OP environment.

70552 for the MRI.

A9578X17 Units for Gadobenate dimeglumine (MultiHance).

77301 might be applicable.  I know next to nothing about Radiation, so I'm only using an encoder product which suggests I visit that code assignment for radiation planning.

Hopefully your facility is catching payment under APC, making those codes about all you'd have to worry with.  Hopefully I've helped somewhat.

Good luck.


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## jmehalich (Apr 21, 2008)

Thank you Kevin.. This one is very confusing. I am still researching. 
Jackie Mehalich RN CPC


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## hodgeskm (Apr 21, 2008)

In regards to reply above regarding 77301 - this is the code for IMRT planning...77295 is used for stereotactic radiosurgery planning by the facility.


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