How To Use CPT Code 70559

CPT 70559 describes the use of magnetic resonance imaging (MRI) during an open intracranial procedure to assess for residual tumor or residual vascular malformation in the brain. 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 70559?

CPT 70559 is a code used to describe the utilization of magnetic resonance imaging (MRI) during an open intracranial procedure. This procedure is performed to assess for any remaining tumor or vascular malformation in the brain. The MRI is conducted without the use of contrast material initially, followed by the administration of contrast material and further sequences to obtain additional images.

2. Official Description

The official description of CPT code 70559 is: ‘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.’

3. Procedure

1. During an open intracranial procedure, the healthcare provider performs magnetic resonance imaging (MRI) of the brain, including the brain stem and skull base.
2. The MRI is conducted without the use of contrast material initially to obtain baseline images.
3. After the initial MRI, the provider administers contrast material and performs further sequences to capture additional images.
4. The MRI allows the provider to assess for any residual tumor or vascular malformation in the brain.
5. The images obtained during the procedure help the provider plan the surgical path, preserve healthy tissue, verify the removal of diseased tissue, and detect any potential problems.

4. Qualifying circumstances

CPT 70559 is used when an open intracranial procedure is performed to assess for residual tumor or residual vascular malformation in the brain. This procedure is typically conducted during neurosurgical procedures, such as those for oncologic purposes or epilepsy. The MRI is performed by a healthcare provider using magnetic fields and radio waves to visualize the brain structures. It is important to note that CPT code 70559 should not be reported in conjunction with codes 61751, 77021, or 77022.

5. When to use CPT code 70559

CPT code 70559 should be used when an open intracranial procedure is performed, and magnetic resonance imaging (MRI) is utilized to assess for residual tumor or residual vascular malformation in the brain. This code is appropriate when the MRI is conducted without the use of contrast material initially, followed by the administration of contrast material and further sequences to obtain additional images.

6. Documentation requirements

To support a claim for CPT code 70559, the healthcare provider must document the following information:

• Indication for the open intracranial procedure and the need for MRI assessment
• Date and time of the MRI procedure
• Whether contrast material was used and the specific sequences performed
• Findings from the MRI, including any residual tumor or vascular malformation
• Signature of the healthcare provider performing the procedure

7. Billing guidelines

When billing for CPT code 70559, ensure that the procedure meets the criteria for an open intracranial procedure and the use of MRI for assessment. It is important to note that CPT code 70559 should not be reported in conjunction with codes 61751, 77021, or 77022. Additionally, consider payer policies regarding the separate reporting of contrast material and any applicable supply codes. Modifier 26 should be appended to the radiology code if reporting only the physician’s interpretation, while modifier TC should be appended for reporting only the technical component.

8. Historical information

CPT code 70559 was added to the Current Procedural Terminology system on January 1, 2004. There have been no updates to the code since its addition.

9. Examples

1. A neurosurgeon performs an open intracranial procedure to remove a brain tumor. During the procedure, an MRI is conducted without contrast material, followed by the administration of contrast material and further sequences to assess for any residual tumor.
2. An oncologic neurosurgical procedure is performed to correct a vascular malformation in the brain. The provider utilizes MRI imaging without contrast material initially, and then repeats the procedure with contrast material and further sequences to ensure complete correction of the malformation.
3. A patient with epilepsy undergoes an open intracranial procedure to address their condition. The healthcare provider performs an MRI without contrast material, followed by the administration of contrast material and further sequences to assess for any residual vascular malformation contributing to the seizures.
4. A neurosurgeon performs an open intracranial procedure to remove a brain tumor. During the procedure, an MRI is conducted without contrast material, followed by the administration of contrast material and further sequences to verify the complete removal of the tumor.
5. A patient with a known vascular malformation in the brain undergoes an open intracranial procedure for correction. The provider utilizes MRI imaging without contrast material initially, and then repeats the procedure with contrast material and further sequences to ensure successful correction of the malformation.
6. An oncologic neurosurgical procedure is performed to remove a brain tumor. The healthcare provider conducts an MRI without contrast material, followed by the administration of contrast material and further sequences to assess for any residual tumor.
7. A patient with epilepsy undergoes an open intracranial procedure to address their condition. The provider performs an MRI without contrast material, followed by the administration of contrast material and further sequences to verify the absence of any residual vascular malformation contributing to the seizures.