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Magnetic resonance imaging (MRI) is a sophisticated imaging technique that utilizes the magnetic properties of hydrogen atoms present in the body to create detailed images of internal structures. Specifically, CPT® Code 70542 refers to MRI performed on the orbit, face, and/or neck regions with the use of contrast material. This noninvasive procedure does not involve ionizing radiation, making it a safer alternative for patients requiring imaging of these sensitive areas. During the MRI process, the patient is positioned on a motorized table that moves into a large cylindrical scanner, which houses a powerful magnet. The magnetic field generated by the scanner aligns the hydrogen atoms in the body, and radiowaves are then transmitted through this field. As the protons in various tissues respond to the radiowaves, they emit radiofrequency signals that are captured and processed by a computer. This results in high-resolution, three-dimensional images that provide critical insights into the condition of the orbit, face, and neck. MRI of the orbit is particularly valuable for diagnosing conditions such as tumors, infections, and inflammation affecting the eye and surrounding tissues, as well as assessing damage to the optic nerve. Similarly, MRI of the face and neck is instrumental in identifying abnormalities in the mouth, throat, nasal passages, and other soft tissues, aiding in the detection of tumors, infections, and other pathological conditions. The use of contrast material, such as gadolinium, enhances the visibility of certain structures and abnormalities, allowing for a more accurate diagnosis. If MRI is performed without contrast, a different code (CPT® 70540) is used, while CPT® 70543 is designated for cases where initial imaging is done without contrast followed by additional imaging with contrast.
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Magnetic resonance imaging (MRI) of the orbit, face, and/or neck with contrast material is indicated for a variety of clinical scenarios. The following conditions and symptoms may warrant the use of this imaging technique:
The procedure for performing an MRI of the orbit, face, and/or neck with contrast material involves several key steps to ensure accurate imaging and patient safety. First, the patient is positioned comfortably on a motorized table that is designed to slide into the MRI scanner. The technician ensures that the patient is properly aligned within the scanner to capture the necessary images. Next, an intravenous (IV) line is established to administer the contrast material, typically gadolinium, which enhances the visibility of certain structures during imaging. Once the IV is in place, the patient is instructed to remain still as the MRI machine is activated. The powerful magnet creates a strong magnetic field, and radiowaves are emitted to stimulate the hydrogen atoms in the body. The protons in the tissues respond by emitting radiofrequency signals, which are collected by the MRI machine. The computer processes these signals to generate high-resolution, three-dimensional images of the orbit, face, and neck. The entire imaging process usually takes between 30 to 60 minutes, depending on the specific areas being examined and the complexity of the case. After the imaging is complete, the technician will remove the IV line, and the patient can resume normal activities unless otherwise instructed.
After the MRI procedure is completed, patients are typically monitored for a short period to ensure there are no immediate adverse reactions to the contrast material. Most patients can return to their normal activities right away, as there are generally no restrictions following the procedure. However, it is advisable for patients to drink plenty of fluids to help flush the contrast material from their system. The physician will review the MRI images, noting any abnormalities or areas of concern, and will provide a written interpretation of the findings. This report is essential for guiding further diagnostic or therapeutic decisions based on the results of the imaging study.
| Short Descr | MRI ORBIT/FACE/NECK W/DYE | Medium Descr | MRI ORBIT FACE & NECK W/CONTRAST MATERIAL | Long Descr | Magnetic resonance (eg, proton) imaging, orbit, face, and/or neck; with contrast material(s) | Status Code | Active Code | Global Days | XXX - Global Concept Does Not Apply | PC/TC Indicator (26, TC) | 1 - Diagnostic Tests for Radiology Services | Multiple Procedures (51) | 4 - Special payment adjustment rules on the technical component (TC) of multiple diagnostic imaging 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 | 88 - | APC Status Indicator | Codes That May Be Paid Through a Composite APC | ASC Payment Indicator | Radiology service paid separately when provided integral to a surgical procedure on ASC list; payment based on MPFS nonfacility PE RVUs. | Type of Service (TOS) | 4 - Diagnostic Radiology | Berenson-Eggers TOS (BETOS) | I2C - Advanced imaging - MRI/MRA: brain/head/neck | MUE | 1 | CCS Clinical Classification | 198 - Magnetic resonance imaging |
This is a primary code that can be used with these additional add-on codes.
| 0649T | Add-on Code MPFS Status: Carrier Priced APC S Quantitative magnetic resonance for analysis of tissue composition (eg, fat, iron, water content), including multiparametric data acquisition, data preparation and transmission, interpretation and report, obtained with diagnostic MRI examination of the same anatomy (eg, organ, gland, tissue, target structure); single organ (List separately in addition to code for primary procedure) | 0698T | Add-on Code Resequenced Code MPFS Status: Carrier Priced APC S ASC Z2 Quantitative magnetic resonance for analysis of tissue composition (eg, fat, iron, water content), including multiparametric data acquisition, data preparation and transmission, interpretation and report, obtained with diagnostic MRI examination of the same anatomy (eg, organ, gland, tissue, target structure); multiple organs (List separately in addition to code for primary procedure) |
| 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. | MH | Unknown if ordering professional consulted a clinical decision support mechanism for this service, related information was not provided to the furnishing professional or provider | 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 | 51 | Multiple procedures: when multiple procedures, other than e/m services, physical medicine and rehabilitation services or provision of supplies (eg, vaccines), are performed at the same session by the same individual, the primary procedure or service may be reported as listed. the additional procedure(s) or service(s) may be identified by appending modifier 51 to the additional procedure or service code(s). note: this modifier should not be appended to designated "add-on" codes (see appendix d). | 52 | Reduced services: under certain circumstances a service or procedure is partially reduced or eliminated at the discretion of the physician or other qualified health care professional. under these circumstances the service provided can be identified by its usual procedure number and the addition of modifier 52, signifying that the service is reduced. this provides a means of reporting reduced services without disturbing the identification of the basic service. note: for hospital outpatient reporting of a previously scheduled procedure/service that is partially reduced or cancelled as a result of extenuating circumstances or those that threaten the well-being of the patient prior to or after administration of anesthesia, see modifiers 73 and 74 (see modifiers approved for asc hospital outpatient use). | 59 | Distinct procedural service: under certain circumstances, it may be necessary to indicate that a procedure or service was distinct or independent from other non-e/m services performed on the same day. modifier 59 is used to identify procedures/services, other than e/m services, that are not normally reported together, but are appropriate under the circumstances. documentation must support a different session, different procedure or surgery, different site or organ system, separate incision/excision, separate lesion, or separate injury (or area of injury in extensive injuries) not ordinarily encountered or performed on the same day by the same individual. however, when another already established modifier is appropriate it should be used rather than modifier 59. only if no more descriptive modifier is available, and the use of modifier 59 best explains the circumstances, should modifier 59 be used. note: modifier 59 should not be appended to an e/m service. to report a separate and distinct e/m service with a non-e/m service performed on the same date, see modifier 25. | 77 | Repeat procedure by another physician or other qualified health care professional: it may be necessary to indicate that a basic procedure or service was repeated by another physician or other qualified health care professional subsequent to the original procedure or service. this circumstance may be reported by adding modifier 77 to the repeated procedure or service. note: this modifier should not be appended to an e/m service. | CR | Catastrophe/disaster related | GA | Waiver of liability statement issued as required by payer policy, individual case | GC | This service has been performed in part by a resident under the direction of a teaching physician | MA | Ordering professional is not required to consult a clinical decision support mechanism due to service being rendered to a patient with a suspected or confirmed emergency medical condition | MC | Ordering professional is not required to consult a clinical decision support mechanism due to the significant hardship exception of electronic health record or clinical decision support mechanism vendor issues | MD | Ordering professional is not required to consult a clinical decision support mechanism due to the significant hardship exception of extreme and uncontrollable circumstances | ME | The order for this service adheres to appropriate use criteria in the clinical decision support mechanism consulted by the ordering professional | MF | The order for this service does not adhere to the appropriate use criteria in the clinical decision support mechanism consulted by the ordering professional | MG | The order for this service does not have applicable appropriate use criteria in the qualified clinical decision support mechanism consulted by the ordering professional | Q1 | Routine clinical service provided in a clinical research study that is in an approved clinical research study | 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 | Ordering professional consulted a qualified clinical decision support mechanism for this service and the related data was provided to the furnishing professional | X5 | Diagnostic services requested by another clinician: for reporting services by a clinician who furnishes care to the patient only as requested by another clinician or subsequent and related services requested by another clinician; this modifier is reported for patient relationships that may not be adequately captured by the above alternative categories; reporting clinician service examples include but are not limited to, the radiologist's interpretation of an imaging study requested by another clinician | XE | Separate encounter, a service that is distinct because it occurred during a separate encounter | XS | Separate structure, a service that is distinct because it was performed on a separate organ/structure | XU | Unusual non-overlapping service, the use of a service that is distinct because it does not overlap usual components of the main service |
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| 2007-01-01 | Changed | Code description changed. |
| 2001-01-01 | Added | First appearance in code book in 2001. |
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