CCI Edits for MRI and MRA

on Friday, 04 June 2010. All News Items

In April 2010, a hospital CCI edit was introduced involving CPT codes representing MRI and MRA procedure for the same anatomic location. The effective date was retroactive to January.

We sent an inquiry to NCCI asking for clarification.  We did not receive a reply, but a reply to the same question was published by as follows:

Thank you for your inquiry regarding National Correct Coding Initiative (NCCI) edits that bundle magnetic resonance imaging (MRI) with magnetic resonance angiography (MRA) services.

These NCCI were implemented on January 1, 2010. The edits bundle MRI procedures with MRA procedures for the same anatomic location. The higher paying code is the column one code for each edit pair. The edits are based on the principle that both codes of an edit pair should not be reported together for a single study. A provider should not perform a single study, generate images for separate MRI procedure and MRA procedure reports, and report separate MRI and MRA common procedural terminology (CPT) codes. The Centers for Medicare & Medicaid Services(CMS) allows the use of NCCI-associated modifiers (e.g., modifier 59) for situations where two separate and distinct studies corresponding to an edit pair are performed on the same date of service.

This information will be added in the 2010 annual update to the National Correct Coding Initiative Policy Manual for Medicare Services this summer which will be posted on CMS' website on October 1, 2010.

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