Radiology Coding Alert

Question: We are billing for MRI of the brain and MRA of the head. Can the codes 70553 and 70544 be unbundled when performed at the same session, with the same indication for both studies?

North Carolina Subscriber

Answer: It is possible that you may report codes 70553 (Magnetic resonance [e.g., proton] imaging, brain [including brain stem]; without contrast material, followed by contrast material[s] and further sequences) and 70544 (Magnetic resonance angiography, head; without contrast material[s]) together.

According to chapter IX of the CCI manual, you can report for magnetic resonance imaging and magnetic resonance angiography procedures together for the same anatomic location in limited circumstances. When your radiologist does a technical study to generate images for separate MRI and MRA reports, you can report only one procedure, either the MRI or MRA, for the same anatomic region. 

You can report, an MRI and MRA, for the same anatomic region if they are performed at separate patient encounters or if two separate and distinct technical studies, one for the MRI and one for the MRA, are performed at the same patient encounter. However, it is unlikely that you find a medical necessity for the latter situation.

According to CCI edit guidelines, when your radiologist does a full and complete brain MRI separately from a full and complete MRA examination, with a separate data set acquisition, you can report both the MRI and MRA codes. In this case, you will also append the 59 (Distinct procedural service) modifier to designate that separate and distinct studies were performed.