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Magnetic resonance imaging (MRI) of the breast, coded as CPT® 77048, is a sophisticated imaging procedure that utilizes powerful magnetic fields and radio waves to create detailed images of breast tissue. This procedure is specifically designed to be performed on one breast (unilateral) and involves both non-contrast and contrast-enhanced imaging techniques. MRI is a non-invasive and non-radiating method, making it a valuable tool in breast imaging. The process begins with the patient lying on a motorized table that is positioned within a large MRI machine, often referred to as a tunnel. To ensure the patient remains still during the imaging process, a sedative may be administered. During the MRI, the hydrogen atoms in the body respond to the magnetic field and radiofrequency signals, emitting radiofrequency signals that are captured and processed by a computer. This results in high-resolution, three-dimensional images of the breast's internal structures. The initial images are obtained without the use of contrast material, followed by a second set of images after a contrast dye is injected. The contrast material enhances the visibility of certain areas within the breast, allowing for better differentiation of tissues. Additionally, the procedure may incorporate real-time computer-aided detection (CAD) technology, which employs advanced algorithms to analyze the MRI images for potential lesions. This CAD system assists in identifying and characterizing any suspicious areas within the breast by marking regions that may require further investigation. It is important to note that the markings generated by the CAD system do not automatically indicate the presence of malignancy; rather, they highlight areas that warrant closer examination. Overall, CPT® 77048 represents a comprehensive approach to breast imaging, combining advanced technology with detailed analysis to aid in the detection and characterization of breast lesions.
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The procedure coded as CPT® 77048 is indicated for various clinical scenarios where detailed imaging of the breast is necessary. The following conditions may warrant the use of this MRI technique:
The procedure for CPT® 77048 involves several key steps that ensure comprehensive imaging of the breast. The following outlines the procedural steps:
After the completion of the MRI procedure, the patient may be monitored briefly to ensure there are no immediate adverse reactions to the contrast material. Patients are typically advised to drink plenty of fluids to help flush the contrast dye from their system. The results of the MRI will be interpreted by a radiologist, who will provide a detailed report to the referring physician. Follow-up appointments may be scheduled to discuss the findings and any necessary next steps, which could include additional imaging, biopsy, or treatment options based on the results. It is important for patients to communicate any concerns or symptoms they may experience following the procedure to their healthcare provider.
| Short Descr | MRI BREAST C-+ W/CAD UNI | Medium Descr | MRI BREAST W/OUT&WITH CONTRAST W/CAD UNILATERAL | Long Descr | Magnetic resonance imaging, breast, without and with contrast material(s), including computer-aided detection (CAD real-time lesion detection, characterization and pharmacokinetic analysis), when performed; unilateral | 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 | Code Not Recognized by OPPS when submitted on Outpatient Hospital Part B Bill Type (12x/13x) | Type of Service (TOS) | 4 - Diagnostic Radiology | Berenson-Eggers TOS (BETOS) | none | MUE | 1 |
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. | RT | Right side (used to identify procedures performed on the right side of the body) | LT | Left side (used to identify procedures performed on the left side of the body) | 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). | 53 | Discontinued procedure: under certain circumstances, the physician or other qualified health care professional may elect to terminate a surgical or diagnostic procedure. due to extenuating circumstances or those that threaten the well being of the patient, it may be necessary to indicate that a surgical or diagnostic procedure was started but discontinued. this circumstance may be reported by adding modifier 53 to the code reported by the individual for the discontinued procedure. note: this modifier is not used to report the elective cancellation of a procedure prior to the patient's anesthesia induction and/or surgical preparation in the operating suite. for outpatient hospital/ambulatory surgery center (asc) 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). | 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. | 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 | JZ | Zero drug amount discarded/not administered to any patient | 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 | ME | The order for this service adheres to 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 | 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 | Q1 | Routine clinical service provided in a clinical research study that is in an approved clinical research study | Ordering professional consulted a qualified clinical decision support mechanism for this service and the related data was provided to the furnishing professional | 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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| 2019-01-01 | Added | Added |
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