HCPCS Code Details - C8904

HCPCS Level II Code
Temporary Codes for Use with Outpatient Prospective Payment System
HCPCS Code C8904
Description

Long description:
Magnetic resonance imaging without contrast, breast; unilateral

Short description:
Mri w/o cont, breast, uni

HCPCS Modifier1
HCPCS Pricing indicator 53 - Statute
Multiple pricing indicator A - Not applicable as HCPCS priced under one methodology
Statute number 1833(t)(2)
Coverage code D - Special coverage instructions apply
BETOS2 code I2D - Advanced imaging - MRI/MRA: other
HCPCS Action code N - No maintenance for this code
Type of service 4 - Diagnostic radiology
Effective date Effective Jan 01, 2019
Date added Added Oct 01, 2001
Termination date Dec 31, 2018
HCPCS Coding Procedures

HCPCS Modifiers

In HCPCS Level II, modifiers are composed of two alpha or alphanumeric characters.

Example: E0260-NU - Hospital bed, semi-electric (head and foot adjustment), with any type side rails, with mattress
NU” identifies the hospital bed as new equipment

See also

  • HCPCS C8903 · Magnetic resonance imaging with contrast, breast; unilateral

  • HCPCS C8905 · Magnetic resonance imaging without contrast followed by with contrast, breast; unilateral

  • HCPCS C8906 · Magnetic resonance imaging with contrast, breast; bilateral

  • HCPCS C8907 · Magnetic resonance imaging without contrast, breast; bilateral

  • HCPCS C8908 · Magnetic resonance imaging without contrast followed by with contrast, breast; bilateral

  • HCPCS S8042 · Magnetic resonance imaging (mri), low-field


1 Two-digit numeric codes are Level I code modifiers copyrighted© by the American Medical Association's Current Procedural Terminology (CPT).

2 BETOS stands for “Berenson-Eggers Type Of Service”