Update for Multiple Imaging Procedures: CT, CTA, MRI and MRA

Claims for the following imaging procedures submitted for the same date that do not clearly document that the imaging studies were performed during separate sessions will be reimbursed according to the payment policy for “multiple (different) anatomic sites/ same session.” This policy allows payment for the technical component at full payment (100%) of the highest priced scan followed by a reduction to 50% for subsequent scans and payment for the professional component at full payment (100%) of the highest priced scan followed by a reduction to 75% for subsequent scans: Computed Tomography (CT), Computed Tomography Angiography (CTA),Magnetic Resonance Imaging (MRI) and Magnetic Resonance Angiography (MRA). Providers will be reimbursed for separate sessions only when documentation submitted with the claim clearly indicates two different sessions. Required documentation includes the times of the scans, CPT codes and evidence or statement that the scans were not performed in the same session. In lieu of documentation, the actual imaging reports may be submitted as proof of the separate services provided.

Source: General Medicine | January 2013 | Bulletin 463