The code
| Code | Used for | Base units |
|---|---|---|
| 01922 | Non-invasive imaging or radiation therapy (such as MRI or CT) | 7 |
Base units shown are the standard values most payers use. Check your payer and the current year's CMS base unit file before relying on them.
Medical necessity
Payers want to know why the patient couldn't have the scan without anesthesia. Common reasons are young age, developmental conditions, severe claustrophobia, movement disorders or pain. Write the reason in the record in plain words. Vague notes like "patient anxious" are a common cause of denials.
Children
For very young children, a qualifying circumstance for extreme age (99100) may apply with payers that pay for it. See qualifying circumstances.
Working outside the OR
Imaging suites are a different setting with different staff. Make sure your times are recorded the same way they would be in the OR, and that the case list from radiology matches what you bill.
This article is general information, not billing, legal or tax advice. Payer rules change; always check current guidance.
Sources
- CMS: Medicare Claims Processing Manual, Chapter 12 (Anesthesia)
- Maryland Workers' Compensation Commission: anesthesia base unit values