Radiology Coding Alert

Question: What’s the diagnosis code for a pre- magnetic resonance imaging (MRI) metal screening?

Texas Subscriber

Answer: This is a question that sparks plenty of debate within radiology billing practices. Some practices use Z01.89 (Encounter for other specified special examinations), while others may use Z03.89 (Encounter for observation for other suspected diseases and conditions ruled out) or Z13.5 (Encounter for screening for eye and ear disorders). Fortunately, an ICD-10-CM Coding Clinic addresses this question by referencing the following ICD-10-CM guidelines found in Section IV.K:

• “For encounters for routine laboratory/radiology testing in the absence of any signs, symptoms, or associated diagnosis, assign Z01.89, Encounter for other specified special examinations. If routine testing is performed during the same encounter as a test to evaluate a sign, symptom, or diagnosis, it is appropriate to assign both the Z code and the code describing the reason for the non-routine test.”

However, just because you’ve got a definitive answer in Z13.89 doesn’t necessarily mean the claim will be paid. Pre-MRI screening X-rays have a notoriously high denial rate, so be prepared to appeal the claim or write off the denial, depending on your practice guidelines.