The codes are divided into two categories. 76014-76016 are assigned for pre-safety planning ahead of the date for the procedure. 76017-76019 are assigned for those safety services occurring on the same day as the MRI.
The first codes we will examine are:
76014 MR safety implant and/or foreign body assessment by trained clinical staff, including identification and verification of implant components from appropriate sources (eg, surgical reports, imaging reports, medical device databases, device vendors, review of prior imaging), analyzing current MR conditional status of individual components and systems, and consulting published professional guidance with written report; initial 15 minutes
+76015 each additional 30 minutes
76016 MR safety determination by a physician or other qualified health care professional responsible for the safety of the MR procedure, including review of implant MR conditions for indicated MR examination, analysis of risk vs clinical benefit of performing MR examination, and determination of MR equipment, accessory equipment, and expertise required to perform examination, with written report
Again, these codes are assigned when the safety planning is done before the date of the MRI procedure. Documentation must be made in the medical record of any contraindications, or the safety conditions that should be followed based on the source review. Add-on code 76015 indicates a greater complexity to the review which required substantially extra time to complete. This code should be assigned in addition to 76014 but cannot be used more than three times per encounter.
Code 76016 would be used in the event that a physician or other qualified health care professional (QHP) is the individual who is responsible for assuring the safe use of the MRI and provides a written report. This may be necessary if there is no FDA labeling which addresses conditions under which the implant may be safely scanned in the MRI, or if an MRI has been contraindicated for a particular device.
The remaining new codes are assigned if the safety planning is taking place on the day of the MRI and done under the supervision of the provider or QHP.
76017 MR safety medical physics examination customization, planning and performance monitoring by medical physicist or MR safety expert, with review and analysis by physician or other qualified health care professional to prioritize and select views and imaging sequences, to tailor MR acquisition specific to restrictive requirements or artifacts associated with MR conditional implants or to mitigate risk of non-conditional implants or foreign bodies, with written report
76018 MR safety implant electronics preparation under supervision of physician or other qualified health care professional, including MR-specific programming of pulse generator and/or transmitter to verify device integrity, protection of device internal circuitry from MR electromagnetic fields, and protection of patient from risks of unintended stimulation or heating while in the MR room, with written report
76019 MR safety implant positioning and/or immobilization under supervision of physician or other qualified health care professional, including application of physical protections to secure implanted medical device from MR-induced translational or vibrational forces, magnetically induced functional changes, and/or prevention of radiofrequency burns from inadvertent tissue contact while in the MR room, with written report
Code 76017 may be assigned in addition to codes 76018 and 76019. 79017 is used when a medical physicist or MRI safety expert determines the priority and selection of views and sequences and the plan is reviewed by a provider or QHP again with a written report documented in the patient’s medical record.
76018 is for implant electronics preparation. This could include verifying the integrity of the device, protection of the patient from device stimulation that is unintended or overheating, or protecting the circuitry of the device from the electromagnetic fields of the MRI. A written report is once again required.
Finally, code 76019 is used when an implant is positioned or immobilized prior to the MRI. This could require the use of physical protections to protect the implant from vibrational forces or prevent radiofrequency burns. This code, too, requires a written report in the medical record.
Interrogation or programming may be necessary for some devices like pacemakers, defibrillators, or neurostimulators. Those codes can be found in the code series for their respective devices. In these instances, it is only appropriate to add code 76018 if a separate provider does additional preparation of the electronic device into MRI-safe mode immediately before the MRI.
Now, light has been shed on coding for MRI Safety.
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