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Topics:
Radiation Oncology • Genitourinary Cancers
How do you obtain approval for an MRI prostate for radiation planning?
If a patient has had a diagnostic MRI, can you obtain another planning MRI after fiducial marker and SpaceOAR placement?
Answer from: Radiation Oncologist at Community Practice
Approval of another MRI using diagnostic CPT codes (e.g. 72197) is unlikely. CPT 76498 (unlisted MRI procedure) is commonly used for radiation treatment-planning MRIs, such as for brain and prostate. As an example, see eviCore's Onc-1.5 policy on this.
Have users seen repeated denials of CPT 76498 ...
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Answer from: Radiation Oncologist at Community Practice
We try to get approval.