Question:

We perform treatment-simulation planning in our magnetic resonance imaging (MRI) for brain and prostate radiation procedures. The radiologist does not interpret these exams; they are performed just to send the images to other systems for their use. Is there an appropriate charge code for this type of imaging? In the past we have used 76498 but our charge-master coordinator does not think that is appropriate. Any guidance you can give is appreciated.

Answer:

Code 76498—unlisted magnetic resonance procedure (e.g., diagnostic, interventional—is the code recommended for MRI for radiation therapy treatment planning by the American Medical Association and American College of Radiology (ACR) in Clinical Examples in Radiology.

However, if the images are obtained for simulation, then they are included in the simulation codes (77280–77290). The CPT® book includes the following information:

“Simulation is the process of defining relevant normal and abnormal target anatomy, and acquiring the images and data necessary to develop the optimal radiation treatment process for the patient.”


CPT® is a registered trademark of the American Medical Association.

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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Fee schedules, relative value units, conversion factors and/or related components are not assigned by the AMA, are not part of CPT, and the AMA is not recommending their use. The AMA does not directly or indirectly practice medicine or dispense medical services. The AMA assumes no liability for data contained or not contained herein.

CPT is a registered trademark of the American Medical Association.