ALL >> Health >> View Article
Three Answer Prior To Reporting Mr Urogram

ABN
Pre-authorization problem may need ABN.
If your practice carries out MR urograms, you need to be all keyed up to handle a few reimbursement hitches.
You may find conflicting information in researching ways to code MR urograms. For instance, you may come across sources that say to report both abdominal and pelvic MRIs, but you will have to reconcile this advice with certain payers preauthorizing only an abdominal exam.
Safeguard yourself: The MR urogram issue reveals various questions that need to be looked into:
First, what did the treating physician order?
What did your facility carry out and document?
Thirdly, what did the insurance company authorize?
For both exams, insist on orders
1. See to it that you have orders from the treating physician for both abdominal and pelvic MRI exams before you think about reporting both - for instance, 74183(Magnetic resonance [e.g., proton] imaging, abdomen; ...
... without contrast material[s], followed by with contrast material[s] and further sequences) and 72197 (Magnetic resonance [e.g., proton] imaging, pelvis; without contrast material[s], and further sequences) for exams carried out without and with contrast.
Auditors will want to take a look at precise orders, so you shouldn't assume that an MR urography" order refers to abdomen and pelvis. Do not be tempted to think otherwise just because you can easily find support that physicians consider MR urography to cover pelvis and abdomen studies. For example, the American College of Radiology (ACR) Appropriateness Criteria for Acute Onset Flank Pain" refers to MRI abdomen and pelvis with or without contrast (MR urography)." (To find out appropriateness criteria, visit www.acr.org. Select the Quality and Safety Resources" link. Then click on the ACR Appropriateness Criteria link.) However, for your records, precise orders will offer your claim the most vital support.
2. Seek distinct documentation: In order to support reporting both abdomen and pelvis MRIs, see to it that the radiologist has documented both exams clearly. Ideally, the radiologist will record each in a separate paragraph, recounting the organs visualized and pertinent comments and findings. For instance, the abdominal MRI documentation might focus on the kidneys and urinary collecting system for anatomical or physiological abnormalities. The pelvic documentation might review any pelvic floor defects associated with urinary incontinence.
Resource: The ACR provides online practice guidelines for pelvic and abdominal MRIs:
Abdomen:
www.acr.org/SecondaryMainMenuCategories/quality_safety/guidelines/dx/gastro/mri_abdomen.aspx
Pelvis: www.acr.org/SecondaryMainMenuCategories/quality_safety/guidelines/dx/gastro/mri_pelvis.aspx.
3. Review need for ABN
If the insurer preauthorizes only an abdominal MRI, then you can expect the insurer to reimburse only the abdominal MRI. The treating physician may still figure out that both pelvic and abdominal MRI exams are important for the patient. If that's the case, alert the patient that he may be financially responsible for the pelvic MRI. Have him read and sign a waiver or ABN agreeing to cover the cost if he opts for the exam. For Medicare, you should append modifier GA (waiver of liability statement issued as called for by payer policy) to the pelvic MRI code to indicate you have an ABN on file.
ABN alert: Effective April 1, CMS updated modifiers. Modifier GA changes from Waiver of liability statement on file," which simply showed that you have a signed ABN on file, Melinda Brown, CMBS, insurance biller with H. Matt Smith, MD, in Kennewick, Wash says.
The new descriptor is Waiver of liability statement issued as called for by payer policy." You should go for modifier GA only to report when a required ABN was issued for a service," according to CMS.
Add Comment
Health Articles
1. Surrogacy In 2025: What To Expect And How The Laws Are EvolvingAuthor: Surrogacy Centre India
2. Arnica As A Medicine
Author: Rade Radosavljevic
3. An Ultimate Guide To Surviving The First 48 Hours After Wisdom Teeth Removal
Author: Will Sievier
4. Understanding The Different Types Of Dental Implants
Author: Paulo Pinho
5. How Smoking And Alcohol Affect Wisdom Teeth Removal Recovery
Author: Paulo Pinho
6. White Star Dental Clinic – Your Trusted Partner For A Healthy Smile
Author: White Star Dental Clinic
7. How Long Do Invisible Braces Take To Work? What To Expect
Author: Charlie Wellish
8. Order Online Ayurvedic Medicine: Heal Naturally At Home
Author: ayushmedi
9. Impacted Wisdom Teeth: Symptoms, Risks, And Treatment Options
Author: Paulo Pinho
10. Get The Best Online Cake Delivery Mumbai Can Offer
Author: Loveandcheesecake
11. 5-day Apple Diet Plan For Effective Weight Loss
Author: Go Moringa Dietician / Nutritionist in Gurgaon
12. Dental Treatment For Nervous Patients At Kaa Dentals
Author: KAA dentals
13. Consult An Eye Specialist Doctor In Thane For Better Sight
Author: Anil Eye Hospital
14. Do Wisdom Teeth Affect Your Other Teeth? Understanding Crowding And Shifting
Author: Paulo Pinho
15. Motivation Is Simpler Than You Think
Author: Impaakt Magazine