MRI Expert Witness Experience
An MRI expert witness who is engaged to provide an opinion on the cost of care must consider the technical component and the professional component as well as global charges for MRIs, the geographic region where the services were provided as well as possibly other factors such as the Affordable Care Act or value based care such as Medicare Advantage. Mr. Arrigo has demonstrated experience in state and federal cases regarding MRIs including retention to provide opinion in litigation between national automobile insurance company and MRI providers. Evaluate nationwide diagnostic imaging reimbursement for professional component (PC) and technical component (TC) focusing on Magnetic Resonance Imaging (MRI) Usual, Customary and Reasonable pricing, CPT coding and billing and resulting charges, and supporting clinical data – Criteria for determining reasonable charges 45 CFR §405.502. National pricing opinion and state opinion in those states with no-fault automobile insurance.
Pricing opinion including but not limited to:
|72141||Magnetic resonance (eg, proton) imaging, spinal canal and contents, cervical; without contrast material|
|72148||Magnetic resonance (eg, proton) imaging, spinal canal and contents, lumbar; without contrast material|
|72146||Magnetic resonance (eg, proton) imaging, spinal canal and contents, thoracic; without contrast material|
|70551||Magnetic resonance (eg, proton) imaging, brain (including brain stem); without contrast material|
|73221||Magnetic resonance (eg, proton) imaging, any joint of upper extremity; without contrast material(s)|
|73721||Magnetic resonance (eg, proton) imaging, any joint of lower extremity; without contrast material|
|70553||Magnetic resonance (eg, proton) imaging, brain (including brain stem); without contrast material, followed by contrast material(s) and further sequences|
A detail explanation and description of CPT 72141 for example: Magnetic resonance imaging (MRI) is done on the cervical spinal canal and contents. MRI is a noninvasive, non-radiating imaging technique that uses the magnetic properties of nuclei within hydrogen atoms of the body. The powerful magnetic field forces the hydrogen atoms to line up. Radiowaves are then transmitted within the strong magnetic field. Protons in the nuclei of different types of tissues emit a specific radiofrequency signal that bounces back to the computer, which records the images. The computer processes the signals and converts the data into tomographic, 3D, sectional images in slices with very high resolution. The patient is placed on a motorized table within a large MRI tunnel scanner that contains the magnet. MRI scans of the spine are often done when conservative treatment of back/neck pain is unsuccessful and more aggressive treatments are considered or following surgery. In 72141, no contrast medium is used. In 72142, a contrast dye is administered first to see the spinal area better before images are taken. The physician reviews the images to look for specific information that may correlate to the patients symptoms, such as abnormal spinal alignment; disease or injury of vertebral bodies; intervertebral disc herniation, degeneration, or dehydration; the size of the spinal canal to accommodate the cord and nerve roots; pinched or inflamed nerves; or any changes since surgery.