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Magnetic resonance imaging (MRI) is a sophisticated imaging technique utilized to visualize the internal structures of the body, particularly the brain, without the use of ionizing radiation. In the context of CPT® Code 70559, this procedure is specifically performed during open intracranial surgeries. The MRI process leverages the magnetic properties of hydrogen atoms present in the body. When a patient is positioned on a motorized table within a large MRI scanner, a powerful magnetic field is generated, causing the hydrogen atoms to align. Subsequently, radiowaves are transmitted, prompting the protons in various tissues to emit radiofrequency signals. These signals are captured and processed by a computer, resulting in high-resolution, three-dimensional images of the brain. The intraoperative MRI is conducted in a specialized operative imaging suite equipped with an MRI scanner, allowing neurosurgeons to obtain real-time images of the brain during surgery. This capability is crucial for assessing the status of brain tumors, determining whether they have been completely excised, and assisting in the placement of deep brain neurostimulator systems. The integration of MRI during surgical procedures significantly enhances the precision of the operation, minimizing the risk of damaging adjacent brain structures while accessing and removing tumors or placing neurostimulators for conditions such as Parkinson's disease, epilepsy, dystonia, and essential tremor. Furthermore, intraoperative MRI plays a vital role in confirming the successful removal of brain lesions, vascular malformations, or pituitary tumors, thereby contributing to improved surgical outcomes.
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The procedure described by CPT® Code 70559 is indicated for various clinical scenarios during open intracranial surgeries. The following conditions may warrant the use of intraoperative MRI:
The procedure associated with CPT® Code 70559 involves several critical steps that ensure the effective use of MRI during open intracranial surgery. The following outlines the procedural steps:
Post-procedure care following the use of intraoperative MRI during open intracranial surgery typically involves monitoring the patient for any immediate complications related to the surgery or the imaging process. The surgical team will assess the patient's neurological status and ensure that there are no adverse reactions to the contrast material used during the procedure. Additionally, the results of the MRI will be reviewed to confirm the completeness of the tumor resection or the status of any vascular malformations. The patient may require further imaging or follow-up appointments to monitor recovery and assess the long-term outcomes of the surgery.
| Short Descr | MRI BRAIN W/O & W/DYE | Medium Descr | MRI BRAIN OPEN INTRACRANIAL PX W/O & W/CONTRAST | 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(s), followed by contrast material(s) and further sequences | 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. | GC | This service has been performed in part by a resident under the direction of a teaching physician | 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. | 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 | 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 | XS | Separate structure, a service that is distinct because it was performed on a separate organ/structure |
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| 2013-01-01 | Changed | Medium Descriptor changed. |
| 2004-01-01 | Added | First appearance in code book in 2004. |
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