# ICD-9 Code - DX code for an xray



## cjacobs (Aug 21, 2012)

Does anyone know how would you DX code for an xray that is done as a MRI screening for metal?  Thanks for the help.


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## jbrightw (Aug 21, 2012)

Could you please add clarity to your question by mentioning the site of MRI and whether this is screening for metal poisoning or swallowing metal or any other metal exposure....

Brightwin


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## grth97 (Aug 21, 2012)

v87.09


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## cjacobs (Aug 22, 2012)

The MRI peformed along with the Xray could be any site.  They always perfrom an Xray on PTs that have been in contact/working with metal.  They are screening for metal on the xray before performing the MRI. Usually the Xray performed is a skull or orbits.  The reason for exam is always MRI screening for metal.  I hope this helps.


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## MnTwins29 (Aug 22, 2012)

Agree with V87.09, even with the additional clarification.


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## mitchellde (Aug 22, 2012)

Disagree!  That is a code for contact with and (suspected) exposure to a HAZARDOUS metal.
This may not even be the case here.  You cannot make this kind of assumption in coding.
we need to know the reason for the MRI, 
you cannot use a screening code since the patient is not asymptomatic, we have always used the same reason for the MRI for the xray.  Unless there is a know hx of a metal pin or plate then we use a personal hx code.


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## jbrightw (Aug 22, 2012)

*Agree!*

This is not a case to check foreign body in tissues or bones as Debra said, but this MRI is meant to detect the effect of exposure to the metals which is usually studied with X ray flourescence study or MRI to know the influence the metals on bones and tissues. This is commonly done for those who have the risk of exposure to Lead, Nickel, Chromium etc..due to occupational hazards.

I agree with V87.09

Brightwin


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## mitchellde (Aug 22, 2012)

However if there is no documentation to support either known contact with or exposure or suspected exposure to the hazardous metals then we cannot use this code.  The original post states none of these things and we cannot assume this to be true.  She stated they had been working with metal, not hazardous metals.  You can elevate a patient's risk factor to their payer by appending codes like this for payment.  Either query the provider and get this information documented or do not use this code.   The injury code should be sufficient in this case.


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## grth97 (Aug 22, 2012)

A hazard is a situation that poses a level of threat to life, health, property, or environment. Suspected metal in eye is hazardous to the patients health. The providers do not want the metal pulling through the eye during the MRI therefore they do the x-ray to make sure there is no hazardous metals in the eye. I can see where you could look at it as the metal itself being hazardous but you can also look at it as the metal being hazardous to the patient. There is no other code that could explain what the provider is looking for in the x-ray. The provider cannot elaborate more on what he is looking for... Simply metal in the eye before they perform the MRI.


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## mitchellde (Aug 22, 2012)

V87.09 is a code for contact or exposure to a HAZARDOUS METAL, not a hazardous situation that happens to have a metal come in contact with a patient.  a hazardous metal is such as chromium, mercury, cobalt, lead, etc,  These metal we are not to touch or drink or otherwise come into contact with.  By using a code like this you can cause an employer to come under an unecessary review for safety precautions.  This is not the correct code for the situation described.  Unless there is a documented exposure or contact with a hazardous metal then it is incorrect.  Your injury code will be enough.


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