Radiology Coding Alert
Multiple MRIs
Idaho Subscriber
Answer: This is not rare, but some practices report success assigning one code twice (e.g., 73718, magnetic resonance [e.g., proton] imaging, lower extremity other than joint; without contrast material[s]), with modifier -51 (multiple procedures). This modifier alerts local Medicare carriers and other insurers that medical necessity required the procedure to be done twice on one date. The radiologist should clearly document the conditions and reasons for the multiple procedures in the medical record. Furthermore, the radiologist should report the services as two separate and distinct studies (e.g., MRI thigh and MRI calf) rather than an MRI of the lower extremity to include the thigh and calf. The payer may require the documentation before paying the claim.
Other coding professionals advise that practices be careful in instances like these, noting that this approach may not withstand an audit. These experts recommend reporting the study only once, and billing twice may be justified only if two separate orders come in at two different times of the day. Coders should ask insurers for their policies in this situation.
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