Radiology Coding Alert

Question: What new codes will be available for reporting the procedure of fetal MRI in 2016?

New York Subscriber

Answer: CPT^® 2016 will offer two new codes for fetal MRI: 74712 (Magnetic resonance [e.g., proton] imaging, fetal, including placental and maternal pelvic imaging when performed; single or first gestation) or 74713 (… each additional gestation [List separately in addition to code for primary procedure]).

Prove medical necessity:

Remember, in order to use 74712 and/or 74713, you need to prove medical necessity. A fetal MRI could be necessary when:

• the ultrasound reveals an abnormality that the physician cannot define;
• the ultrasonography identifies an abnormality, and the physician needs more information, in the form of a fetal MRI, to decide a course of care; or
• the physician feels that the fetus is at risk for abnormality, even though she finds no definitive markers from the ultrasound.