Mri fetal ea addl gestation
CPT code 74713 covers an MRI scan for each additional fetus beyond the first in a multiple pregnancy (twins, triplets, etc.). This is an add-on code used when imaging more than one baby during the same MRI session.
This calculator gives a typical-case estimate using standard Medicare modifier rules. Actual payment depends on payer policies, documentation, code-specific CMS status indicators, and locality. Verify before billing.
RVU breakdown
Conversion factor: 32.3465 · Source: CMS MPFS RVU25A · Confidence: High
NCCI bundling edits
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Billing tips
Always verify the number of fetuses documented in the ordering physician's request and confirm each fetus was separately evaluated and interpreted
Impact: Prevents underbilling; each additional fetus beyond the first generates $195.70 in Medicare reimbursement
Bill 74713 only in addition to the primary fetal MRI code (74712); this is an add-on code and cannot be billed alone
Impact: Prevents automatic denial; add-on codes without primary codes result in 100% payment denial
Document each fetal position (Baby A, Baby B, etc.) and ensure separate interpretations are clearly delineated in the radiology report
Impact: Reduces audit risk and supports medical necessity; inadequate documentation can trigger post-payment recoupment of $195.70 per questioned fetus
Use modifier 59 when billing multiple units on the same date if payer edits flag potential bundling issues with the primary code
Impact: Prevents inappropriate bundling denials; successful appeal restores $195.70 per add-on unit
Verify gestational age is documented; fetal MRI is typically performed after 18-20 weeks gestation when medically indicated
Impact: Supports medical necessity determination; studies performed too early may be denied as not medically reasonable
Check payer-specific policies on contrast administration in pregnancy as some payers have restrictive coverage for gadolinium use
Impact: Prevents denials for investigational or non-covered services; pre-authorization may be required
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