Question:

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?

Answer:

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.

This question was answered in an edition of our Radiology Compliance Manager. For more hot topics relating to radiology services, please visit our store or call us at 1.800.252.1578, ext. 2.

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