Ask Dr. Z

How would you code for a whole body MRI with a diagnosis of Li-Fraumeni syndrome? The provider wants to bill unlisted. Our coders want to bill each body area. What are your thoughts? "FINDINGS: Neck: Non-enlarged cervical lymph nodes bilaterally. No suspicious mass lesion identified. Thorax: Minimal left basilar atelectasis, likely related to sedation. No pulmonary nodule is identified. This a small area of T2 hyperintensity in the right paraspinal region in the chest (series 401, image 20), which was partially imaged on the prior study, unchanged. This is of uncertain clinical significance and could represent a lymph node.   Abdomen and pelvis: Postsurgical changes of right adrenalectomy. No suspicious mass in the right suprarenal fossa to suggest recurrent tumor. Liver, spleen, pancreas, and kidneys are normal in contour and signal intensity. No mass lesion identified. Trace amount of free fluid in the pelvis, physiologic. Lower extremities: Bone marrow is normal in signal. Muscles are normal in bulk and signal intensity. No abnormal fluid collection."