© Copyright 2025 American Medical Association. All rights reserved.
Magnetic resonance imaging (MRI) is a sophisticated imaging technique utilized to visualize the brain, including the brain stem and skull base, during open intracranial procedures. This procedure is particularly significant as it allows for real-time assessment of the brain's condition while surgery is ongoing. MRI operates on the principle of using strong magnetic fields and radio waves to generate detailed images of the internal structures of the body without the use of ionizing radiation, making it a noninvasive and safe option for patients. During the procedure, the patient is positioned on a motorized table that moves into a large MRI scanner, where the powerful magnetic field aligns the hydrogen atoms present in the body. Subsequently, radiofrequency pulses are applied, causing these protons to emit signals that are captured and processed by a computer to create high-resolution, three-dimensional images. In the context of open intracranial surgery, intraoperative MRI is performed in a specialized operative imaging suite equipped with an MRI scanner. This setup allows neurosurgeons to obtain immediate imaging feedback during critical moments of the surgery, such as when assessing the completeness of tumor resection or the placement of deep brain neurostimulator systems. The ability to visualize the brain in real-time significantly enhances the precision of surgical interventions, minimizes the risk of damaging surrounding healthy brain tissue, and ultimately contributes to improved surgical outcomes. The specific CPT® code 70557 is used to report this procedure when it is conducted without the administration of contrast material, distinguishing it from other related codes that involve contrast-enhanced imaging.
© Copyright 2025 Coding Ahead. All rights reserved.
Magnetic resonance imaging (MRI) of the brain during open intracranial procedures is indicated for several specific reasons, primarily related to the assessment and management of brain conditions. The following are the key indications for performing this procedure:
The procedure for conducting magnetic resonance imaging of the brain during an open intracranial surgery involves several critical steps to ensure accurate imaging and patient safety. The following outlines the procedural steps:
Following the intraoperative MRI, the surgical team will evaluate the images obtained to determine the success of the procedure. If residual tumor or vascular malformation is identified, the surgeon may decide to take further action during the same surgical session. Post-procedure care includes monitoring the patient for any immediate complications related to the surgery and ensuring that they are stable before transitioning to recovery. The use of intraoperative MRI enhances surgical outcomes by providing critical information that can influence the course of the surgery, ultimately leading to better patient management and recovery.
| Short Descr | MRI BRAIN W/O DYE | Medium Descr | MRI BRAIN OPEN INTRACRANIAL PX W/O CONTRAST MATL | Long Descr | Magnetic resonance (eg, proton) imaging, brain (including brain stem and skull base), during open intracranial procedure (eg, to assess for residual tumor or residual vascular malformation); without contrast material | Status Code | Carriers Price the Code | Global Days | XXX - Global Concept Does Not Apply | 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 | ASC Payment Indicator | Radiology service paid separately when provided integral to a surgical procedure on ASC list; payment based on OPPS relative payment weight. | 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 |
| 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. | 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. | GC | This service has been performed in part by a resident under the direction of a teaching physician | GZ | Item or service expected to be denied as not reasonable and necessary | 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 | 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 |
|
Date
|
Action
|
Notes
|
|---|---|---|
| 2004-01-01 | Added | First appearance in code book in 2004. |
Get instant expert-level medical coding assistance.