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BETA v.3.0

2025 CPT code 77048

Magnetic resonance imaging (MRI) of one breast, with and without contrast, including computer-aided detection (CAD).

Modifier 26 should be appended for the professional component only, TC for the technical component only. For global service, no modifier is needed. Check payer guidelines for contrast agent reporting.

Modifiers 26, TC, 59, and others may apply based on the circumstance.

Medical necessity should be documented based on established guidelines (e.g., ACR Appropriateness Criteria) for breast MRI usage, such as high-risk screening, evaluation of palpable masses, or post-surgical follow-up.

The radiologist performs the MRI, administers contrast if needed, interprets images, and may use CAD software for analysis. They create a report detailing findings.

IMPORTANT:For bilateral breast MRI with contrast, use code 77049. For breast MRI without contrast, see codes 77046 and 77047.

In simple words: An MRI scan of one breast is taken with and without a special dye to help see any abnormalities. A computer program helps the doctor analyze the images.

This code represents a unilateral breast MRI examination using contrast material, incorporating computer-aided detection (CAD) for real-time lesion identification, characterization, and pharmacokinetic analysis. The procedure includes both non-contrast and contrast-enhanced MRI sequences. The radiologist interprets the images and may use CAD software for further analysis.

Example 1: A patient with a palpable lump in her right breast undergoes a unilateral MRI with contrast and CAD analysis to assess the lesion., A high-risk patient with a family history of breast cancer has a screening breast MRI of the left breast with contrast and CAD., A patient who had a lumpectomy two years prior undergoes a follow-up unilateral MRI of the affected breast to check for recurrence, utilizing contrast and CAD analysis.

Medical record should include patient history, indication for the exam, laterality, contrast administration details, CAD usage details, and the radiologist’s interpretation report.

** Separate reporting of the contrast agent may be allowed per payer guidelines, potentially using code 99070 or HCPCS Level II codes.

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