Medical Billing Codes 70551-70553

Using Medical Billing Codes 70551-70553 for MRI and IAC Properly

There are many times in medical billing when a patient receives both an IAC and brain MRI. The question is, can the medical biller be reimbursed for both of these services separately?

If the medical billing personnel asked the American Medical Association this question, the answer would be simple. They would say that you can absolutely get separately reimbursed for an IAC and brain MRI in the same session. Realistically, however, this is not exactly true. The requirement to code for both x-rays is that they need two separate and distinct exams. Each exam is required to have distinct findings. It’s a catch 22 because realistically, this is close to impossible.

In the rare instance that an exam meets the necessary criteria for distinctly separate reimbursement, the chances are that the payer will not look at it this way. After going through the tedious steps of having a separate exam for the IAC and brain MRI, in most cases insurance companies will still not pay. This ends up being a waste of time and effort for medical billing purposes.

Medical billing firms have personnel that are specifically trained to recover the most money possible for your practice. By outsourcing your medical billing, you are taking advantage of this valuable resource. They can assist you on a long term basis dealing with all your medical billing duties. They can also assist you on a temporary consulting basis if that is what your needs warrant. Medical billing is a complicated process and should only be handled by the most experienced and trained individuals.

If following text book guidelines, it is stated that CPT codes 70551-70553 for IAC and brain MRIs can be coded separately. Realistically, however, this is a medical billing myth.

View all Articles by: Melissa Clark, CCS-P