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CPT Code 77049 | MRI & CAD Analysis Of The Breasts (Bilateral)

CPT code 77049 is used for magnetic resonance imaging of the breasts, including computer-aided detection analysis and contrast material, with a written report by the provider, and is used for both breasts.

What Is CPT Code 77049?

CPT code 77049 is used for magnetic resonance imaging (MRI) of the breasts, both with and without the use of contrast material, as well as computer-aided detection (CAD) analysis.

This procedure involves using radiofrequency waves and a strong magnetic field to produce images of the breast tissue, which may be enhanced with the injection of a contrast medium.

The CAD software analyzes the images and produces colorized representations of areas of abnormal perfusion. It may also perform routine measurements and apply pharmacokinetic modeling to the data. Finally, the provider reviews the results and produces a written report.


The CPT book describes CPT code 77049 as: “Magnetic resonance imaging, breast, without and with contrast material(s), including computer-aided detection (CAD real-time lesion detection, characterization, and pharmacokinetic analysis), when performed; bilateral.”


The provider investigates the anatomy of both breasts using radiofrequency waves sent from an MRI scanner having a strong magnetic field.

These radiofrequency waves cause the hydrogen atoms in the body to release radio signals. A computer receives these radio signals and converts them into breast images.

The provider injects a contrast medium intravenously into the patient and takes additional images. After the provider takes diagnostic contrast–enhanced MRI scans of the breast, he may use a CAD software program to analyze the images and produce colorized images reflecting areas where abnormal perfusion is present.

The computer program corrects false elements appearing in images caused by patient movement during scanning and then assigns a color to each pixel based on the contrast enhancement, such as red to indicate malignancy, green to indicate suspicious tissue, and blue to indicate benignity.

The software can also perform many routine measurements the provider takes to measure the size and extent of a lesion.

The computer program then automates the final assessment by arranging all the MRI images in a dynamic contrast–enhanced (DCE) time sequence and applies pharmacokinetic parameter maps using pharmacokinetic modeling. This mathematical model predicts how chemicals such as the contrast material may be absorbed, distributed, and metabolized.

The provider evaluates the data before finalizing his findings and dictating a report.

How To Use CPT 77049

CPT code 77049 is used for bilateral (both) breasts. Report CPT 77048 for the same procedure on one breast. Use CPT 77046 and CPT 77047 for breast MRI without contrast.

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