How To Use CPT Code 70542

CPT 70542 describes the use of magnetic resonance imaging (MRI) with contrast material(s) to obtain high-resolution three-dimensional images of the orbits, face, and/or neck. This article will cover the description, procedure, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information, similar codes and billing examples.

1. What is CPT Code 70542?

CPT 70542 is used to describe the use of MRI with contrast material(s) to obtain detailed images of the orbits, face, and/or neck. This code is used when the provider needs to diagnose various disorders, including tumors, in these areas. The MRI machine uses magnetic fields and radio waves to create high-resolution three-dimensional images of the internal structures being studied.

2. Official Description

The official description of CPT code 70542 is: ‘Magnetic resonance (eg, proton) imaging, orbit, face, and/or neck; with contrast material(s).’ This code includes the injection of contrast material(s) and the acquisition of multi-sequence and multi-planar images of the specified areas.

3. Procedure

1. The provider positions the patient on the MRI table, which slides into the machine resembling a large tube.
2. The provider injects contrast material(s) into the patient, either intravenously or through other routes, to improve the visibility of internal structures or organs.
3. The provider uses the MRI machine to create high-resolution three-dimensional images of the orbits, face, and/or neck.
4. The machine creates a magnetic field and directs radio waves at the patient’s body, aligning the patient’s hydrogen atoms.
5. The aligned atoms produce signals that a computer uses to create detailed cross sections of the target area, helping the provider identify tumors and other abnormalities.

4. Qualifying circumstances

CPT 70542 is used when the provider needs to obtain images of the orbits, face, and/or neck with the use of contrast material(s) to diagnose various disorders, including tumors. The contrast material(s) must be administered intravascularly, intraarticularly, or intrathecally. Providers who supply contrast may also separately report the contrast using a supply code or a HCPCS Level II code, depending on payer policies.

5. When to use CPT code 70542

CPT code 70542 should be used when the provider performs an MRI with contrast material(s) to obtain detailed images of the orbits, face, and/or neck for diagnostic purposes. This code should not be used when the MRI is performed without contrast material(s) or when the MRI includes other areas of the body.

6. Documentation requirements

To support a claim for CPT 70542, the provider must document the following information:

• Indication for the MRI with contrast material(s)
• Type and route of contrast material(s) administered
• Date and time of the procedure
• Specific areas imaged (orbits, face, and/or neck)
• Findings and impressions from the MRI
• Signature of the provider performing the procedure

7. Billing guidelines

When billing for CPT 70542, ensure that the MRI is performed with contrast material(s) in the specified areas. If the provider administers oral or rectal contrast, the service should be reported as without contrast. Modifier TC should be appended to the radiology code when reporting only the technical component, and modifier 26 should be appended when reporting only the professional component. Payer policies may vary, so it is important to check individual guidelines for contrast coverage and reportable supply codes.

8. Historical information

CPT 70542 was added to the Current Procedural Terminology system on January 1, 2001. On January 1, 2007, the code description was changed to include the neck in addition to the orbits and face.

9. Examples

1. A provider performs an MRI with contrast material(s) to obtain detailed images of a patient’s orbits for the evaluation of a suspected tumor.
2. An MRI with contrast material(s) is performed on a patient’s face to assess the extent of a facial injury following a traumatic accident.
3. A provider orders an MRI with contrast material(s) to evaluate a patient’s neck for the presence of abnormal lymph nodes.
4. An MRI with contrast material(s) is performed on a patient’s orbits and face to investigate the cause of chronic sinusitis.
5. A provider performs an MRI with contrast material(s) on a patient’s neck to assess the extent of a suspected thyroid tumor.
6. An MRI with contrast material(s) is ordered to evaluate a patient’s orbits and face for the presence of vascular malformations.
7. A provider performs an MRI with contrast material(s) on a patient’s face to assess the extent of a suspected salivary gland tumor.
8. An MRI with contrast material(s) is performed on a patient’s orbits and neck to investigate the cause of unexplained eye pain.
9. A provider orders an MRI with contrast material(s) to evaluate a patient’s face for the presence of abnormal bone growth.
10. An MRI with contrast material(s) is performed on a patient’s orbits and face to assess the extent of a suspected optic nerve lesion.