CPT® Code 0724T | Case2Code

Official Description

Quantitative magnetic resonance cholangiopancreatography (QMRCP), including data preparation and transmission, interpretation and report, obtained with diagnostic magnetic resonance imaging (MRI) examination of the same anatomy (eg, organ, gland, tissue, target structure) (List separately in addition to code for primary procedure)

Common Language Description

Quantitative magnetic resonance cholangiopancreatography (QMRCP) is an advanced imaging technique that enhances the standard magnetic resonance cholangiopancreatography (MRCP) procedure. MRCP itself is a specialized form of magnetic resonance imaging (MRI) that captures detailed three-dimensional images of the pancreas, gallbladder, liver, and bile ducts without the need for invasive procedures. This noninvasive approach utilizes a powerful magnetic field, radiofrequency pulses, and sophisticated computer algorithms to generate high-resolution images of the biliary and pancreatic anatomy. The primary purpose of MRCP is to evaluate conditions such as pancreatitis and to identify potential abnormalities, including tumors, gallstones, inflammation, or infections within the biliary tract. QMRCP builds upon the foundational MRCP by incorporating additional software that provides quantitative analysis of the acquired 3D images. This software generates volumetric measurements of the entire biliary tree and assesses the diameter of the ducts, offering critical metrics that aid in the characterization of biliary duct abnormalities, such as strictures and dilations. These quantitative assessments are particularly valuable in differentiating primary sclerosing cholangitis from other hepatic inflammatory diseases prior to treatment and in monitoring for the development of cholangiocarcinoma. The QMRCP process requires an operator who is specifically trained in the use of the software to effectively process the MRCP images, enhance the visualization of the biliary ducts, segment the gallbladder, and accurately model the biliary tree. It is important to note that QMRCP is reported separately in addition to the primary procedure code for an abdominal MRI when performed concurrently on the target organ.

1. Indications

QMRCP is indicated for the evaluation of various conditions affecting the biliary and pancreatic systems. The following are specific indications for performing this procedure:

Assessment of Pancreatitis QMRCP is utilized to evaluate the pancreas in cases of pancreatitis, helping to identify any complications or underlying causes.
Detection of Tumors The procedure aids in the identification of tumors within the pancreas, gallbladder, liver, and bile ducts, providing critical information for diagnosis and treatment planning.
Identification of Stones QMRCP is effective in detecting gallstones or other obstructive lesions within the biliary tract that may cause symptoms or complications.
Evaluation of Inflammation or Infection The imaging technique is used to assess inflammatory conditions or infections in the biliary system, allowing for appropriate management.
Characterization of Biliary Duct Abnormalities QMRCP provides detailed metrics that help distinguish between different types of biliary duct abnormalities, such as strictures and dilations.

2. Procedure

The QMRCP procedure involves several key steps to ensure accurate imaging and analysis of the biliary and pancreatic systems. The following outlines the procedural steps:

Step 1: Patient Preparation Prior to the QMRCP, the patient is prepared for the MRI examination, which may include fasting for a specified period to reduce the presence of food in the gastrointestinal tract that could interfere with imaging quality.
Step 2: MRI Acquisition The patient is positioned within the MRI machine, and a standard MRCP sequence is performed. This involves the use of a powerful magnetic field and radiofrequency pulses to capture detailed images of the biliary and pancreatic anatomy.
Step 3: Data Processing After the MRCP images are acquired, an operator trained in QMRCP software processes the images. This step includes enhancing the biliary ducts, segmenting the gallbladder into distinct sections, and differentiating biliary ducts from gastrointestinal components.
Step 4: Quantitative Analysis The processed images are analyzed to generate volumetric measurements of the entire biliary tree and assess the diameter of the ducts. This quantitative data is crucial for identifying abnormalities and characterizing conditions affecting the biliary system.
Step 5: Interpretation and Reporting A physician evaluates the processed images and quantitative data, providing a comprehensive report that includes findings related to the biliary and pancreatic systems, as well as any identified abnormalities.

3. Post-Procedure

After the QMRCP procedure, patients may be monitored briefly to ensure there are no immediate adverse reactions to the MRI. Since QMRCP is a noninvasive imaging technique, there is typically no recovery time required, and patients can resume normal activities shortly after the examination. The results of the QMRCP will be discussed with the patient during a follow-up appointment, where the physician will review the findings and recommend any necessary further evaluations or treatments based on the results.

Short Descr	QMRCP W/DX MRI SAME ANATOMY
Medium Descr	QMRCP W/DIAGNOSTIC MRI SAME ANATOMY
Long Descr	Quantitative magnetic resonance cholangiopancreatography (QMRCP), including data preparation and transmission, interpretation and report, obtained with diagnostic magnetic resonance imaging (MRI) examination of the same anatomy (eg, organ, gland, tissue, target structure) (List separately in addition to code for primary procedure)
Status Code	Carriers Price the Code
Global Days	ZZZ - Code Related to Another Service
PC/TC Indicator (26, TC)	1 - Diagnostic Tests for Radiology Services
Multiple Procedures (51)	0 - No payment adjustment rules for multiple procedures apply.
Bilateral Surgery (50)	0 - 150% payment adjustment for bilateral procedures does NOT apply.
Physician Supervisions	09 - Concept does not apply.
Assistant Surgeon (80, 82)	0 - Payment restriction for assistants at surgery applies to this procedure...
Co-Surgeons (62)	0 - Co-surgeons not permitted for this procedure.
Team Surgery (66)	0 - Team surgeons not permitted for this procedure.
Diagnostic Imaging Family	99 - Concept Does Not Apply
APC Status Indicator	Procedure or Service, Not Discounted when Multiple
Berenson-Eggers TOS (BETOS)	none
MUE	1

This is an add-on code that must be used in conjunction with one of these primary codes.

74181	MPFS Status: Active Code APC Q3 ASC Z3 PUB 100 CPT Assistant Article Magnetic resonance (eg, proton) imaging, abdomen; without contrast material(s)
74182	MPFS Status: Active Code APC Q3 ASC Z2 PUB 100 CPT Assistant Article Magnetic resonance (eg, proton) imaging, abdomen; with contrast material(s)
74183	MPFS Status: Active Code APC Q3 ASC Z2 PUB 100 CPT Assistant Article Magnetic resonance (eg, proton) imaging, abdomen; without contrast material(s), followed by with contrast material(s) and further sequences

26	Professional component: certain procedures are a combination of a physician or other qualified health care professional component and a technical component. when the physician or other qualified health care professional component is reported separately, the service may be identified by adding modifier 26 to the usual procedure number.
Q6	Service furnished under a fee-for-time compensation arrangement by a substitute physician or by a substitute physical therapist furnishing outpatient physical therapy services in a health professional shortage area, a medically underserved area, or a rural area
TC	Technical component; under certain circumstances, a charge may be made for the technical component alone; under those circumstances the technical component charge is identified by adding modifier 'tc' to the usual procedure number; technical component charges are institutional charges and not billed separately by physicians; however, portable x-ray suppliers only bill for technical component and should utilize modifier tc; the charge data from portable x-ray suppliers will then be used to build customary and prevailing profiles