Radiology Coding Alert

Question: Our radiologist sometimes performs myolysis with MR guidance. Is there a way to code this to obtain reimbursement?


Virginia Subscriber

Answer: Unless you have payer guidance to the contrary, you probably won't be reimbursed for this procedure. If you know your payer won't cover the procedure, plan to inform the patient of her financial liability and get any paperwork you need on file, such as an advance beneficiary notice, to charge the patient.

Many payers consider myolysis using high-intensity focused ultrasound (HIFU) to be new and experimental. You should report the HIFU procedure with Category III codes 0071T (Focused ultrasound ablation of uterine leiomyomata, including MR guidance; total leiomyomata volume less than 200 cc of tissue) or 0072T (... total leiomyomata volume greater than or equal to 200 cc of tissue). The descriptor includes MR guidance, so don't code for this separately.

When you'll see myolysis: Physicians use myolysis to shrink uterine fibroids most frequently by using externally administered HIFU or by inserting probes to cause devascularization and ultimately ablation. MR guidance helps in probe insertion and produces thermal imaging maps.

Note: Uterine fibroids may also be treated using embolotherapy under angiographic guidance and monitoring. Most payers do cover this service.

The answers for You Be the Coder and Reader Questions were reviewed by Jackie Miller, RHIA, CPC, senior consultant with Coding Strategies Inc. in Powder Springs, Ga.; and Gary S. Dorfman, MD, FACR, FSIR.