Neurology & Pain Management Coding Alert

Question: Should I report 70554 or 70555 when a physician selects and interprets function brain MRIs if a tech administers neurofunctional tests during image acquisition?

Illinois Subscriber

Answer: You should report 70554 (Magnetic resonance imaging, brain, functional MRI; including test selection and administration of repetitive body part movement and/or visual stimulation, not requiring physician or psychologist administration) when a physician or psychologist does not administer the entire neurofunctional tests.

But if a physician or psychologist designs and administers the neurofunctional tests, report 96020 (Neurofunctional testing selection and administration during noninvasive imaging functional brain mapping, with test administered entirely by a physician or psychologist, with review of test results and report). Submit 70555 (Magnetic resonance imaging, brain, functional MRI; requiring physician or psychologist administration of entire neurofunctional testing) for the physician who interprets the images.

CPT guidelines instruct you not to report 70555 unless a physician performs 96020 and not to report 70554 or 70555 with brain MRI codes 70551-70553 unless you have documentation of a separate diagnostic MRI.