CPT codes (Current Procedural Terminology) are standardized identifiers used by healthcare providers to report medical, surgical, and diagnostic services to insurance payers. These codes ensure a uniform language for billing and medical record keeping. CPT 70553 is the specific code assigned to a highly detailed Magnetic Resonance Imaging (MRI) examination of the brain. This procedure provides a comprehensive view of brain structures to investigate complex neurological symptoms.
Defining CPT 70553
The CPT code 70553 specifically identifies an MRI of the brain and brainstem performed both without and with the use of a contrast material. This procedure is a two-part study completed during a single session, providing two distinct sets of images for the radiologist to compare. The initial sequence is captured without any contrast agent to establish a baseline image of the anatomical structures. The second sequence is then captured after the contrast material has been administered to the patient intravenously.
This approach distinguishes CPT 70553 from related codes. CPT 70551 is for an MRI performed solely without contrast, while CPT 70552 represents an MRI performed only with contrast material. Billing CPT 70553 signals that the patient received the most comprehensive form of brain MRI to maximize diagnostic clarity.
The Role of Contrast in Brain Imaging
The contrast material used is a Gadolinium-based agent, administered intravenously during the examination. Gadolinium influences the magnetic properties of water molecules, causing tissues where the agent accumulates to appear brighter, or “enhanced,” on the resulting MRI images.
Under normal circumstances, the brain is protected by the blood-brain barrier (BBB), a layer of specialized cells that prevents large molecules, including the Gadolinium agent, from leaving the bloodstream and entering the brain tissue. The contrast agent is hydrophilic, meaning it does not readily cross this intact barrier.
If a disease process, such as a tumor, infection, or inflammation, has damaged the blood-brain barrier, the contrast agent leaks out of the vessels and accumulates in the surrounding abnormal tissue. This accumulation causes the damaged area to light up brightly on the post-contrast images. This makes subtle lesions that were invisible on the non-contrast images much easier to detect and characterize.
What Happens During the Procedure
The technologist begins by ensuring the patient has removed all metal objects and confirming there are no contraindications, such as a pacemaker or certain implants. An intravenous (IV) line is placed, typically in the arm or hand, for the contrast injection. The patient then lies down on the table and enters the MRI machine.
The patient is provided with earplugs or headphones because the MRI machine produces loud knocking and buzzing noises during scanning. Remaining completely still is required for the entire scan, which typically lasts between 30 and 60 minutes, to prevent image blurring. The technologist communicates with the patient via an intercom system throughout the process.
The first half of the examination consists of the non-contrast imaging sequences. Once these baseline images are acquired, the technologist administers the Gadolinium contrast agent through the established IV line. The patient may experience a brief sensation of warmth or a metallic taste during this injection. The second set of contrast-enhanced images is then acquired immediately following the injection.
Conditions Diagnosed Using CPT 70553
A physician orders an MRI with and without contrast when a condition is suspected that causes a breakdown in the blood-brain barrier, making enhanced images necessary for diagnosis. This comprehensive study is the standard for evaluating suspected brain tumors, including primary growths or metastases. The contrast helps to delineate the size and borders of these masses.
The procedure is also commonly used to investigate new-onset seizures when the underlying cause is not clear. CPT 70553 is the preferred method for assessing infections of the central nervous system, such as a cerebral abscess or meningitis, where inflammation disrupts the blood-brain barrier. Certain inflammatory and demyelinating diseases, like multiple sclerosis, are also evaluated using this method, as the contrast can highlight active lesions.