Billing and Coding: Automated Detection and Quantification of Brain Magnetic Resonance Imaging

Medicare will pay for primary brain MRI CPT codes 70551, 70552, and 70553, but automated detection/quantification add-on codes CPT 0865T and 0866T are not covered and are not eligible for additional payment. Claims must include a valid ICD-10-CM diagnosis and required referring/ordering physician information when applicable, follow NCCI/OPPS coding rules, and comply with ABN modifier procedures (GA/GX/GZ/GY) including CMS-R-131 and occurrence code 32 for Part A as appropriate.

"Primary brain MRI procedure codes CPT 70551, 70552, and 70553 are eligible for Medicare payment when billed appropriately."

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