Question:

What code would we assign for a magnetic resonance imaging (MRI), face only? Should we add modifier -52 on 70540 or bill a maxillofacial MRI?

Answer:

You would choose a code from 70540–70543 depending on the use of contrast.  It is not necessary to report modifier -52.

70540 Magnetic resonance (e.g., proton) imaging, orbit, face, and/or neck; without contrast material(s)
70542 with contrast material(s)
70543 without contrast material(s), followed by contrast material(s) and further sequences

As you can see, the code description includes “and/or,” indicating that one or more of the areas listed could be imaged for this code to be used. If you image only the face, only the orbits, or only the neck (soft tissue) without contrast, you still assign code 70540. If you do image any two areas (i.e., orbits and neck; or face and neck), you still assign 70540 (once), and if you image all three areas, it’s still 70540 once.


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

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