Variability in billing practices for whole-body magnetic resonance imaging: reply to Degnan et al.
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We would like to thank Degnan and colleagues  for their insightful comments regarding our recent article on utilization and procedural practices in pediatric whole-body MRI. As was stated in our article and expanded upon by Degnan and colleagues, billing practices are variable for pediatric whole-body MRI . The lack of dedicated Current Procedural Terminology (CPT) codes for whole-body MRI permits this variability, exacerbates billing challenges, and may ultimately lead to patient care challenges.
As an imaging community, we should work toward a cohesive definition of what encompasses a whole-body MRI examination in the pediatric patient population. Our article revealed the amount of variability that exists in what body parts are included in an exam that is labeled as a whole-body MRI . An initial task in creating a whole-body MRI procedure-specific code is to define what parts of the body must be imaged to constitute a “whole-body” MRI. While standardization of coverage is necessary, formulating a requisite standardized set of sequences for pediatric whole-body MRI is impractical because of the need to account for patient-, provider- and institution-specific variables. Rather, guidelines for best practices (including sequence selection and plane of imaging) could be delivered via an entity such as the American College of Radiology Appropriateness Criteria. Such appropriateness criteria could provide valuable guidance and further definition.
Whole-body MRI is a valuable imaging tool in pediatric patients that must continue to be further defined. Ultimately, determining the constituent body parts, establishing guidelines for best practices, and creating procedure-specific billing codes will all help improve pediatric whole-body MRI.
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Conflicts of interest
- 1.Degnan AJ, Alson MD, Duszak R (2018) Variability in billing practices for whole-body MRI. Pediatr Radiol. https://doi.org/10.1007/s00247-018-4255-0