Radiology Question for the Week of October 16, 2017

Question:

Would it be a contrast-only MRI/MRA scan if localizer scans only are done pre-contrast and most of the diagnostic imaging is done only after contrast administration? In other words, would a non-contrast followed by contrast scan code only apply if additional imaging beyond localizers was done after contrast?

Answer:

It is not appropriate to report a non-contrast study of any type (computed tomography [CT] or magnetic resonance imaging [MRI]) based on localizer images only. MRI always involves “localizer” scans to pre­scribe any scans, contrast or not. Counting the localizer noncontrast images as sufficient for coding purposes as a noncontrast portion of a “without and with contrast” exam would be inappropriate in the absence of diagnostic sequences performed prior to contrast administration. Specifically, the localizer images are not meant to be used as a non-contrast portion of the examination and should not be coded as such. (ACR Coding Source, July/August 2015)

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