Radiology Coding Alert

Question: Can I bill for the technical component of a magnetic resonance imaging (MRI) scan if there’s no dictation report to go along with it? I’ve been told that as long as the images are saved, we may bill for the technical component.

Washington Subscriber

Answer: While there may not be any specific guidelines on this matter, you should never bill for the technical component of a scan until the radiologist performs the interpretation. There are numerous reasons for this, but the most important is your determination of the correct CPT^® code hinges on the provider’s interpretation.

For instance, if you want to bill out for a three-view hip X-ray, but the provider only documents two views in the technique, then you are over coding the procedure unless you can get the provider to include an addendum for a third view. The same concept goes with a MRI scan. If the use, or non-use, of contrast in the technique does not match up with the code submitted with the TC (Technical Component) modifier, you’ve once again miscoded the procedure.

Lastly, it’s not only the technique that needs to be taken into consideration when determining the correct CPT^® code. Some exams, such as 76801 (Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation, first trimester (< 14 weeks 0 days), transabdominal approach; single or first gestation) or 76770 (Ultrasound, retroperitoneal (eg, renal, aorta, nodes), real time with image documentation; complete) require that a certain number of anatomical criteria be met before submitting to insurance. Without the provider’s interpretation, the facility has no way of knowing the correct code to report when billing for the technical component.