You Be the Coder:
Abdominal, Extremity MRAs
Published on Wed May 01, 2002
Test your coding knowledge. Determine how you would code this situation before looking at the box below for the answer.
Question: When we perform MRAs from the diaphragm to the toes, should we charge an MRA of the lower extremities? Or can we code the procedure to include the upper portion?
Montana Subscriber
Answer: You should report the magnetic resonance angiography (MRA) with 74185 (Magnetic resonance angiography, abdomen, with or without contrast material[s]) and 73725 (Magnetic resonance angiography, lower extremity, with or without contrast material[s]). Documentation must support each service billed. Separate paragraphs for the abdominal MRA and each extremity should be recorded because each will be reimbursed separately.
If both extremities are imaged, unilateral code 73725 may be reported twice with the body-side modifiers (-RT, Right side; and -LT, Left side). Some payers may require different reporting of the duplicated service. For instance, 73725 may be reported on two lines of the claim form, with modifier -50 (Bilateral procedure) appended to the second appearance, or it may appear on only one line with modifier -50 and a 2 in the units field.
CMS does not adjust its reimbursement levels for 73725 when performed bilaterally as it does with other select codes. The bilateral surgery column of the Physician Fee Schedule categorizes 73725 with a 2, indicating that no fee adjustment is made because the relative value units for the code assume a bilateral procedure.
Medicare has also assigned a status code of R (Restricted coverage) to 74185 and 73725. This indicates that special coverage instructions apply and, if covered, the services are carrier priced.
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