Radiology Coding Alert

Question: Non-contrast magnetic resonance imaging (MRI) scans of the left wrist and the left shoulder were performed by different providers on the same day. I was told to report one of the two services with modifier 59. Is that correct?

Mississippi Subscriber

Answer: Since you’ve got two separate radiologists interpreting the scans, you might assume it makes sense to use modifier 77 (Repeat procedure by another physician or other qualified health care professional) to distinguish between the services. However, modifiers 77 and 76 (Repeat procedure or service by same physician or other qualified health care professional) do not qualify for reporting in this scenario. That’s because despite the fact that you report the same code for a non-contrast MRI of the wrist and an MRI of the shoulder, the services are not “repeat” procedures.

Regardless of whether the same provider or two distinct providers performed the set of MRIs, the coding will remain the same. For the first service, you will report 73221 with modifier LT (Left side). You will report the second 73221 service with modifiers LT and 59 (Distinct procedural service), or XS (Separate structure, a service that is distinct because it was performed on a separate organ/structure), depending on payer.