Code Bundling Rules for PET/MRI Services
Review how Horizon considers reimbursement of code combinations of eligible PET/MRI services when rendered on the same date of service.
Procedure code 73718 is bilateral eligible.
| Code | Code | Rule | Formula Used for Reimbursement |
| 78812 | 70540 73218 71550 74181 72195 73718 |
When the code from column A is billed with one or more codes from column B | 100% for the PET exam, 50% for the MRI with the highest RVU and 25% for any additional MRIs with lessor RVUs |