How To Use CPT Code 77046

CPT 77046 describes the procedure for obtaining magnetic resonance imaging (MRI) of a single breast without the use of contrast material. This article will cover the official description, procedure, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information, similar codes and billing examples.

1. What is CPT Code 77046?

CPT 77046 can be used to describe the procedure for obtaining MRI images of a single breast without the use of contrast material. This code is used when a provider applies an external magnetic field and radiofrequency waves to create three-dimensional images of the breast.

2. Official Description

The official description of CPT code 77046 is: ‘Magnetic resonance imaging, breast, without contrast material; unilateral.’

3. Procedure

1. The provider uses an MRI scanner with a strong magnetic field to send radiofrequency waves into the body.
2. The radiofrequency waves cause the hydrogen atoms in the breast to release radio signals.
3. A computer receives the radio signals and converts them into three-dimensional images of the breast.
4. The provider analyzes the images to investigate the anatomy of the breast and identify any fibrosis or lesions.
5. The provider finalizes their findings and dictates a report based on the analysis of the images.

4. Qualifying circumstances

CPT 77046 is used when a provider needs to investigate the anatomy of a single breast using MRI without the use of contrast material. This procedure is typically performed to assess the presence of fibrosis or lesions in the breast.

5. When to use CPT code 77046

CPT code 77046 should be used when a provider performs an MRI of a single breast without the use of contrast material. It is important to note that this code is specific to unilateral breast imaging and should not be used for bilateral breast imaging or when contrast material is used.

6. Documentation requirements

To support a claim for CPT 77046, the provider must document the following information:

• Indication for the MRI of the breast without contrast material
• Date and time of the procedure
• Analysis of the images and any findings of fibrosis or lesions
• Dictated report based on the analysis

7. Billing guidelines

When billing for CPT 77046, ensure that the procedure is performed on a single breast without the use of contrast material. It is important to follow payer guidelines regarding the reporting of contrast material separately, if applicable. Modifier 26 should be appended to the radiology code if reporting only the physician’s interpretation, and modifier TC should be appended if reporting only the technical component. However, payer policies may exempt hospitals from appending modifier TC.

8. Historical information

CPT 77046 was added to the Current Procedural Terminology system on January 1, 2019. There have been no updates to the code since its addition.

9. Examples

1. A radiologist performing an MRI of a single breast without contrast material to investigate a suspicious lump.
2. A breast surgeon ordering an MRI of a single breast without contrast material to assess the extent of fibrosis in a patient with a history of breast surgery.
3. An oncologist requesting an MRI of a single breast without contrast material to monitor the response to chemotherapy in a breast cancer patient.
4. A plastic surgeon performing an MRI of a single breast without contrast material to evaluate the results of a breast reconstruction procedure.
5. A primary care physician ordering an MRI of a single breast without contrast material to investigate breast pain in a patient with no previous imaging abnormalities.