How To Use CPT Code 70552

CPT code 70552 describes the use of magnetic resonance imaging (MRI) with contrast material to examine the brain and brain stem. 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 70552?

CPT 70552 can be used to describe the use of MRI with contrast material to examine the brain and brain stem. This code is used when a provider injects contrast and positions the patient on a table that slides into the MRI machine. The machine creates a magnetic field and directs radio waves at the patient’s body to create detailed cross-sectional images of the brain and brain stem.

2. Official Description

The official description of CPT code 70552 is: ‘Magnetic resonance (eg, proton) imaging, brain (including brain stem); with contrast material(s).’ This code includes the use of contrast material to enhance the visibility of internal structures or organs of the brain and brain stem.

3. Procedure

1. The provider injects contrast material into the patient.
2. The patient is positioned on a table that slides into the MRI machine.
3. The MRI machine creates a magnetic field and directs radio waves at the patient’s body.
4. The aligned hydrogen atoms in the patient’s body produce signals that a computer uses to create detailed cross-sectional images of the brain and brain stem.
5. The provider reviews the images to identify tumors, anatomic abnormalities, and foreign bodies.

4. Qualifying circumstances

CPT 70552 is used when a provider uses MRI with contrast material to examine the brain and brain stem. This procedure is typically performed to diagnose, manage, and treat diseases or conditions affecting these structures. The use of contrast material enhances the visibility of internal structures or organs, and it must be administered intravascularly, intraarticularly, or intrathecally.

5. When to use CPT code 70552

CPT code 70552 should be used when a provider performs an MRI of the brain and brain stem with the use of contrast material. It is important to note that if the provider administers oral or rectal contrast, the service should still be reported as ‘with contrast’ because the radiology service includes the use of oral and rectal contrast. However, if the contrast is not administered intravascularly, intraarticularly, or intrathecally, CPT code 70552 should not be used.

6. Documentation requirements

To support a claim for CPT code 70552, the provider must document the following information:

• Administration of contrast material
• Date and time of the procedure
• Specific structures of the brain and brain stem examined
• Findings and any abnormalities identified
• Signature of the provider

7. Billing guidelines

When billing for CPT code 70552, ensure that the procedure involves the use of MRI with contrast material for the examination of the brain and brain stem. It is important to follow payer guidelines regarding the reporting of contrast material separately, as some payers may require the use of additional supply codes. If reporting only the physician’s interpretation or only the technical component, the appropriate modifiers should be appended to the radiology code.

8. Historical information

CPT code 70552 was added to the Current Procedural Terminology system on January 1, 1990. There have been no updates to the code since its addition.

9. Examples

1. A provider performs an MRI with contrast material to examine the brain and brain stem of a patient with suspected brain tumor.
2. An individual undergoes an MRI with contrast material to evaluate the presence of an anatomic abnormality in the brain and brain stem.
3. A provider orders an MRI with contrast material to identify foreign bodies in the brain and brain stem of a patient who experienced a traumatic injury.
4. A patient with a known neurological condition undergoes an MRI with contrast material to monitor disease progression in the brain and brain stem.
5. A provider performs an MRI with contrast material to assess the effectiveness of a treatment in reducing inflammation in the brain and brain stem.
6. An individual undergoes an MRI with contrast material to investigate the cause of persistent headaches affecting the brain and brain stem.
7. A provider orders an MRI with contrast material to evaluate blood flow in the brain and brain stem of a patient with suspected vascular abnormalities.
8. A patient with a history of stroke undergoes an MRI with contrast material to assess the extent of damage in the brain and brain stem.
9. A provider performs an MRI with contrast material to identify the presence of lesions in the brain and brain stem of a patient with multiple sclerosis.
10. An individual undergoes an MRI with contrast material to evaluate the response of a brain tumor to a specific treatment.