Ask Dr. Z

Is there any guidance on how to code an MRI pelvis and MRI sacrum? If ordered separately and medical necessity provided, would they be coded separately, or are they only considered a single exam since they are performed in the same session? If they can be coded separately, would a -59 or -76/77 modifier be appropriate? The only guidance I have found is that if the sacrum is imaged alone, it's coded as an MRI pelvis, and if it's imaged with the spine, it's included in the spine, but nothing on coding both when ordered separately as pelvis and sacrum exams. We have a provider that is stating that they have different protocols on the machine and they cannot just add a few images for the sacrum. Any information you have on this topic would be fantastic.