legreen
New
MRIs of lumbar spine performed in the ED are being denied with a dx of 724.5 (if PT is not ordered first). I have searched for a list of approved codes on the CMS website but have not found anything. PLEASE HELP!! Thanks! 
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Wiki CMS-approved dx codes for Lumbar MRI
- Thread starter legreen
- Start date
mitchellde
True Blue
You have to code form the providers documentation. I agree that backache NOS is not enough to justify an MRI, is there more information in the documentation? if not then it does not matter what is on the approved list.
mitchellde
True Blue
It will need to be documented as low back pain to use that code. That is why I stress the code is dependent on what is documented.
Peter Davidyock
Expert
Medicare has been moving away from paying unspecified codes for a while now. At least that has been my experience. I feel they are doing so to help prepare everyone for the specificity of 10 without being so in your face.