Wiki MRI with contrast

Create Wiki
M

markamanda111@gmail.com

Contributor
Messages
17
Best answers
0
Please help me with this issue. I had a lidocaine and contrast injection into the hip through fluoroscopic guidance and had two images taken. Then I walked to an MRI machine for imagined of the hip labrum? My insurance is telling me I did not have an MRI with contrast but had a hip arthrogram. I explained arthrogram is the old terminology and that the arthrogram part happens just prior to the MRI. They said an arthrogram and MRI with contrast are nowhere near alike. I am floored. What am I missing? I feel I had an MRI with contrast. That is what the doctor called it. In his notes he said he injected lidocaine and contrast material and I walked to the MRI machine where the hip labrum was visualized for any tearing.
 
I don't know what was billed however by Dr Z., it should have billed as 27093 - Hip arthrography, 77002 - fluoroscopic needle localization, and 73722 - For Magnetic resonance imaging, any joint of lower extremity, with contrast material. Arthrogram terminology is still used, but how it is done is different from when I used to do. Good luck with the insurance.

Jim
 
Thanks so much. That was how it was coded and I believe that is correct. I am just not understanding why my insurance feels they can claim this was an outpatient surgery ( when the clinic it was done at was not even an accredited surgery and was a radiology outpatient centre) . They claim just because of 27093 that they therefore, can bill the other claims as surgeries too even though they are labelled as MRI diagnostic and my husbands employer covered all imaging and diagnostics at 100 percent. But insurance says just because of the code 27093, they need to also charge the MRI and fluroscopic guidance as surgical too as they can only choose one code to put everything under. I am not sure if you can advise but does that make any sense?

I would feel the contrast is a diagnostic agent . Just because a CPt code is “ surgical” does not mean they can instantly say any procedure with a surgical code in it is a surgery and bill as such.

I means that would mean if I fell at midnight and went to the ER and they said we need to do an X-ray of the foot to ensure it is not broken and they only found a sprain and then used a surgical code to apply a bandage to restrain the join (code 29540) then that could also all suddenly be a surgery.
 
Jim Pawloski said:
I don't know what was billed however by Dr Z., it should have billed as 27093 - Hip arthrography, 77002 - fluoroscopic needle localization, and 73722 - For Magnetic resonance imaging, any joint of lower extremity, with contrast material. Arthrogram terminology is still used, but how it is done is different from when I used to do. Good luck with the insurance.

Jim
Click to expand...
Would you mind if I sent you the bill or whatever information you needed to evaluate this? I really think Anthem, my insurance, is committing fraud in charging me for outpatient surgical facility ( as it says on my EOB) and charging me all three CPT codes as outpatient surgery , especially when this is only a radiology clinic and all diagnostics , and a imaging , through my plan, are covered 100 percent. Contrast should not suddenly make an MRI an outpatient surgery.
 
Jim Pawloski said:
Sorry I can't help you, but yes this should be an imaging charges and not a surgical center.
Click to expand...
Thanks you. Just that confirmation is more than enough in what I needed. I also have been saying it should be imaging and they keep pushing back it is a surgery because of the contrast dye which is, as I thought, wrong and fraud. I really appreciate that.
 
You must log in or register to reply here.
Top