Chargemaster and Charge Capture

tamaraowings

My Imaging Department is searching for the appropriate code for fMRI liver.  My understanding is that the Department will have orders for imaging of the liver (CPT 74181) but will also have an additional order which calls for some functional liver imaging research sequences at specific time points.  This functional imaging lies outside the normal scope of clinical liver imaging (74181).  Therefore the department is searching for a technical charge for the research portion of the study.    Would these additional sequences be considered to be inclusive in the 74181 or should we report a 76498 for the additional sequences for liver function?

 

dwilliamsrsi

You mention "research sequences" - is this part of a research or clinical study?  If so, then you would follow the research protocol for billing the research company or the clinical study.  Based on the information available regarding fMRI, these are additional sequences that track metabolic activity.  In light of that, there would be additional sequences but no "new" imaging exam.  This would indicate a higher resource cost and support a higher charge, but not a separate code.  But, first, I would investigate if this is research/investigational/study driven and determine if this is separately billable to a payer or if the cost/charge goes to the investigating/research body.