How To Use HCPCS Code C8908

HCPCS code C8908 describes a specific medical procedure known as magnetic resonance imaging (MRI) of the breast. This procedure involves the use of magnetic fields and radio waves to create detailed images of the breast tissue. The code specifies that the MRI is performed without contrast initially, followed by a second MRI with contrast. In this article, we will explore the details of HCPCS code C8908, including its official description, procedure, when to use it, billing guidelines, historical information, and Medicare and insurance coverage.

1. What is HCPCS C8908?

HCPCS code C8908 is used to identify the specific procedure of magnetic resonance imaging (MRI) of the breast. It indicates that the MRI is performed without contrast initially, followed by a second MRI with contrast. This code is used to accurately document and bill for this particular imaging procedure.

2. Official Description

The official description of HCPCS code C8908 is “Magnetic resonance imaging without contrast followed by with contrast, breast; bilateral.” The short description for this code is “Parenteral supp not othrws c.” These descriptions provide a clear understanding of the procedure being performed and the body part involved.

3. Procedure

1. The provider begins by preparing the patient for the MRI procedure.
2. The patient lies down on a table that slides into the MRI machine.
3. The MRI machine uses a combination of magnetic fields and radio waves to create detailed images of the breast tissue.
4. Initially, the MRI is performed without the use of contrast agents.
5. After the initial scan, a contrast agent is administered to the patient.
6. A second MRI scan is then performed with the contrast agent to enhance the visibility of certain structures or abnormalities.
7. Once the imaging is complete, the patient can safely leave the MRI machine.

4. When to use HCPCS code C8908

HCPCS code C8908 should be used when performing a breast MRI procedure that involves both an initial scan without contrast and a subsequent scan with contrast. This code is specifically used for bilateral breast imaging, meaning both breasts are examined during the procedure. It is important to ensure that the procedure performed aligns with the specific details outlined in the code description.

5. Billing Guidelines and Documentation Requirements

When billing for HCPCS code C8908, healthcare providers need to document the details of the procedure, including the use of contrast agents and the fact that the imaging was performed bilaterally. It is essential to include all relevant information in the medical records to support the necessity and accuracy of the billed service. Proper documentation ensures appropriate reimbursement and compliance with coding guidelines.

6. Historical Information and Code Maintenance

HCPCS code C8908 was added to the Healthcare Common Procedure Coding System on January 01, 1985. It has an effective date of January 01, 1996. As indicated by the action code N, no maintenance actions have been taken for this code. This means that there have been no updates or revisions to the code since its addition. It is important to note the historical context of the code to understand its longevity and stability within the coding system.

7. Medicare and Insurance Coverage

HCPCS code C8908 falls under the special coverage instructions category, denoted by the coverage code D. This indicates that specific coverage instructions apply to this code. Medicare and other insurance carriers may have their own pricing indicators and methodologies for determining reimbursement for this procedure. The pricing indicator code 57 signifies that other carriers price this service. The multiple pricing indicator code A indicates that the code is not applicable as HCPCS priced under one methodology. It is crucial to review the individual carrier’s guidelines and policies to determine coverage and reimbursement details.

8. Examples

Here are five examples of scenarios where HCPCS code C8908 would be appropriate:

1. A patient undergoes a bilateral breast MRI without contrast initially, followed by a second MRI with contrast to evaluate a suspected breast abnormality.
2. A patient with a family history of breast cancer undergoes routine screening with a bilateral breast MRI, including both scans without and with contrast.
3. A patient with a known breast tumor undergoes a preoperative MRI evaluation, consisting of both non-contrast and contrast-enhanced scans of both breasts.
4. A patient with a history of breast implants presents with breast pain, and a bilateral MRI is performed to assess the integrity of the implants, including both scans without and with contrast.
5. A patient with a recent breast biopsy undergoes a follow-up MRI examination, including both non-contrast and contrast-enhanced scans of both breasts, to monitor for any residual abnormalities.