MRI of Patients with MRI compatible pacemakers

Medicare believes that the evidence is adequate to conclude that MRIs improve health outcomes for Medicare beneficiaries with implanted Pacemakers (PMs) when the PMs are used according to the FDA-approved labeling for use in an MRI environment. To be paid for and not be audited by the Recovery Auditor, it is necessary to include the following three items in the Medicare claim:

1) Appropriate MRI code

2) KX modifier

3) ICD-9 code V45.01 (cardiac pacemaker)

Inclusion of the KX modifier on the claim lines means that the provider attests that documentation is on file verifying that FDA-approved labeling requirements are met. For such claims without the KX modifier, Medicare will deny the claim.