CPT CODES

CPT Code 70558

CPT code 70558 is for an MRI of the brain with contrast dye, used to enhance imaging for better diagnosis of neurological conditions.

Table of Contents
What is CPT Code 70558
Does CPT 70558 Need a Modifier?
CPT Code 70558 Medicare Reimbursement
Are You Being Underpaid for 70558 CPT Code?
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What is CPT Code 70558

CPT code 70558 is used to describe an MRI (Magnetic Resonance Imaging) of the brain that is performed with the use of a contrast dye. This procedure involves taking detailed images of the brain to help healthcare providers diagnose and monitor various conditions. The contrast dye is injected into the patient's bloodstream to enhance the visibility of certain structures and abnormalities in the brain, providing clearer and more detailed images for the radiologist to interpret. This code is specifically used when both the MRI and the administration of the contrast dye are performed.

Does CPT 70558 Need a Modifier?

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CPT Code 70558 Medicare Reimbursement

The CPT code 70558 is reimbursed by Medicare, subject to specific conditions and guidelines. Reimbursement for this code is determined by the Medicare Physician Fee Schedule (MPFS), which outlines the payment rates for services provided to Medicare beneficiaries. The MPFS is updated annually and considers various factors, including geographic location and practice expenses, to establish reimbursement rates.

Additionally, Medicare Administrative Contractors (MACs) play a crucial role in the reimbursement process. MACs are responsible for processing Medicare claims and ensuring that services meet the necessary coverage criteria. They may have specific local coverage determinations (LCDs) that affect the reimbursement of CPT code 70558. Therefore, healthcare providers should consult their respective MACs to understand any regional policies or documentation requirements that may impact reimbursement for this code.

In summary, while CPT code 70558 is generally reimbursed by Medicare, providers must adhere to the guidelines set forth by the MPFS and consult their MACs for any specific regional requirements or limitations.

Are You Being Underpaid for 70558 CPT Code?

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