If a magnetic resonance imaging (MRI) study is not completed due to the patient being in too much pain, how should this be billed for a non-hospital office? We used a 52 modifier, but Medicare is denying it saying that is an inappropriate modifier. Would you just bill it as a regular study?


If there was enough diagnostic imaging done to obtain a diagnosis, no modifier is needed as there are no specific requirements/elements for MRI. If it was not diagnostic, then 53 may be more appropriate for a non-hospital facility or physician billing because that is discontinued service due to extenuating circumstances.

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