How To Use CPT Code 70551

CPT 70551 is a code used for magnetic resonance imaging (MRI) of the brain without contrast material. This article will cover the description, procedure, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information, similar codes, and examples of CPT 70551 procedures.

1. What is CPT 70551?

CPT 70551 is a code used to describe a specific type of medical imaging procedure, specifically magnetic resonance imaging (MRI) of the brain and brain stem without the use of contrast material. This code is utilized by medical coders and billers to accurately document and bill for this particular diagnostic service.

2. 70551 CPT code description

The official description of CPT code 70551 is: “Magnetic resonance (eg, proton) imaging, brain (including brain stem); without contrast material.”

3. Procedure

The 70551 procedure involves the following steps:

1. The patient is positioned on a table that slides into the MRI machine, which resembles a large tube.
2. The patient remains still while the provider uses the machine to create images of one or more structures of the brain and brain stem without using contrast material.
3. The MRI machine creates a magnetic field and directs radio waves at the patient’s body, aligning the patient’s hydrogen atoms.
4. The aligned atoms produce signals that a computer uses to create images, showing detailed cross sections of the target area.
5. The images help the provider identify tumors, anatomic abnormalities, and foreign bodies within the brain and brain stem.

4. Qualifying circumstances

Patients who are eligible to receive CPT code 70551 services are those who require a detailed examination of their brain and brain stem without the use of contrast material. This may include patients with suspected tumors, anatomic abnormalities, or foreign bodies within the brain and brain stem. Additionally, patients with contraindications to contrast material, such as allergies or kidney issues, may also be eligible for this code.

5. When to use CPT code 70551

It is appropriate to bill the 70551 CPT code when a provider performs an MRI of the brain and brain stem without the use of contrast material. This code should be used when the provider determines that a detailed examination of the brain and brain stem is necessary, but contrast material is not required or is contraindicated for the patient.

6. Documentation requirements

To support a claim for CPT 70551, the following information should be documented:

• Patient’s medical history and reason for the MRI
• Physical examination findings
• Details of the MRI procedure, including the specific structures examined and the absence of contrast material
• Interpretation of the MRI images, including any identified abnormalities or findings
• Provider’s clinical impression and recommendations for further evaluation or treatment, if applicable

7. Billing guidelines

When billing for CPT code 70551, it is important to follow the appropriate guidelines and rules. Some tips and codes that apply to CPT code 70551 include:

• If reporting only the physician’s interpretation for the radiology service, append professional component modifier 26 to the radiology code.
• If reporting only the technical component for the radiology service, append modifier TC to the radiology code. Note that payer policy may exempt hospitals from appending modifier TC because the hospital’s portion is inherently technical.
• Do not append a professional or technical modifier to the radiology code when reporting a global service in which one provider renders both the professional and technical components.
• Depending on the payer’s guidelines, providers who supply contrast may also separately report the contrast using a 99070 supply code or a HCPCS Level II code. Check individual payers’ policies for contrast coverage and reportable supply codes.

8. Historical information

CPT 70551 was added to the Current Procedural Terminology system on January 1, 1990. There have been no updates to the code since its addition.

9. Similar codes to CPT 70551

Five similar codes to CPT 70551 and how they differentiate from CPT 70551 are:

• CPT 70552: This code is used for an MRI of the brain and brain stem with the use of contrast material(s).
• CPT 70553: This code is used for an MRI of the brain and brain stem without contrast material, followed by contrast material(s) and further sequences.
• CPT 70540: This code is used for an MRI of the orbit, face, and/or neck without contrast material.
• CPT 70542: This code is used for an MRI of the orbit, face, and/or neck with contrast material(s).
• CPT 70543: This code is used for an MRI of the orbit, face, and/or neck without contrast material, followed by contrast material(s) and further sequences.

10. Examples

Here are 10 detailed examples of CPT code 70551 procedures:

1. A patient with a history of headaches undergoes an MRI of the brain without contrast to evaluate for possible brain tumor.
2. A patient with a history of seizures undergoes an MRI of the brain without contrast to assess for structural abnormalities.
3. A patient with a history of head trauma undergoes an MRI of the brain without contrast to evaluate for possible brain injury.
4. A patient with a history of visual disturbances undergoes an MRI of the brain without contrast to assess for possible lesions in the brain stem.
5. A patient with a history of dizziness undergoes an MRI of the brain without contrast to evaluate for possible vestibular dysfunction.
6. A patient with a history of cognitive decline undergoes an MRI of the brain without contrast to assess for possible neurodegenerative disease.
7. A patient with a history of hearing loss undergoes an MRI of the brain without contrast to evaluate for possible acoustic neuroma.
8. A patient with a history of facial numbness undergoes an MRI of the brain without contrast to assess for possible trigeminal neuralgia.
9. A patient with a history of unexplained neurological symptoms undergoes an MRI of the brain without contrast to evaluate for possible multiple sclerosis.
10. A patient with a history of stroke undergoes an MRI of the brain without contrast to assess for possible residual damage or new lesions.