AHA Coding Clinic® for HCPCS - 2012 Issue 4; Ask the Editor

Fetal MRI

We are seeking authoritative advice on the correct coding of a fetal MRI. We have found various coding consultants that state that the correct code to use is 72195, 72196 or 72197. The logic given was that the fetus is part of the pelvic contents and therefore, a pelvic MRI code is the appropriate code. On the other hand, the American College of Radiologists states that CPT code 76498, Unlisted magnetic resonance procedure, is the correct code because the evaluation of the fetus requires much more additional work than an MRI of the pelvic organs. In addition, it does seem like the intent of the scan is to image the fetus and the pelvic organs are imaged only incidentally. Fetal MRIs are being done more often so we would appreciate advice on the proper coding of these procedures. ...

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