2025 CPT code 77046
(Active) Effective Date: N/A Revision Date: N/A Deletion Date: N/A Radiology Procedures - Breast MRI Radiology Feed
Magnetic resonance imaging (MRI) of a single breast without contrast material.
Modifiers 26 (professional component) and TC (technical component) may be appended as appropriate based on payer requirements and whether the professional and/or technical components are billed separately. Modifier 59 may be required for distinct procedural services.
Medical necessity for a unilateral breast MRI without contrast is typically established when there is a clinical suspicion of breast pathology, including but not limited to palpable masses, abnormal mammographic findings, or high-risk family history of breast cancer. The test may also be medically necessary as part of a screening program for high-risk individuals.
The radiologist is responsible for performing the MRI, analyzing the images, and generating a report interpreting the findings. This includes identifying any abnormalities, such as masses, cysts, or other lesions.
In simple words: This medical code refers to a special type of scan, an MRI, that takes detailed pictures of one breast without using any special dye. The doctor looks at the pictures to check for any problems.
This CPT code describes the performance of a unilateral breast MRI without the use of contrast material.The procedure involves the use of an external magnetic field and radiofrequency waves to create three-dimensional images of one breast.The radiologist analyzes these images to identify any abnormalities, such as fibrosis or lesions, and generates a report detailing their findings.
Example 1: A 45-year-old female patient presents with a palpable breast mass.A unilateral breast MRI without contrast is ordered to further evaluate the mass before a biopsy., A 38-year-old female patient with a family history of breast cancer undergoes a screening unilateral breast MRI without contrast as part of her preventative care plan., A 60-year-old female patient with breast implants undergoes a unilateral breast MRI without contrast to assess for any implant-related complications or changes.
The following documentation is required:patient demographics, referring physician information, clinical indication for the MRI (e.g., palpable mass, family history, screening), images from the MRI examination, and the radiologist's interpretation report.
** This code should not be used if contrast material is administered.Always refer to payer specific guidelines and local coverage determinations for reimbursement policies.
- Revenue Code: I4B (IMAGING/PROCEDURE - OTHER)
- RVU: Information not available in provided text.Refer to CMS guidelines for current RVU values.
- Global Days: Information not available in provided text.Global period may vary based on payer and other factors.
- Payment Status: Active
- Modifier TC rule: Modifier TC (technical component) can be applied when only the technical aspect of the MRI is billed.This is often handled differently depending on hospital or facility policies.
- Fee Schedule: Fee schedules vary by payer and location.Consult relevant fee schedules for historical data.
- Specialties:Radiology, Breast Surgery, Oncology
- Place of Service:Office, Hospital (Inpatient or Outpatient), Ambulatory Surgical Center, Imaging Center