Neurology & Pain Management Coding Alert

Question: What is a functional magnetic resonance imaging (fMRI), and how do I code for the service? Should I use the same codes as I do for other MRIs?

Iowa Subscriber

Answer: Don’t use the same CPT^® codes for fMRI as you do for other MRIs; the service has its own codes.

A functional MRI (fMRI) is a type of imaging technique that allows providers to observe and analyze brain activity while a person is performing specific tasks or at rest. The study measures changes in blood flow and oxygenation levels in different areas of the brain, providing insights into which regions are active during certain mental processes.

According to CPT^®, “Functional MRI involves identification and mapping of stimulation of brain function. When neurofunctional tests are administered by a technologist or other non-physician or non-psychologist, use 70554 [Magnetic resonance imaging, brain, functional MRI; including test selection and administration of repetitive body part movement and/or visual stimulation, not requiring physician or psychologist administration].

“When neurofunctional tests are entirely administered by a physician or psychologist, use 70555 [… requiring physician or psychologist administration of entire neurofunctional testing].”

Do this: When coding for fMRI, be sure you know who provided the service. It will save you time when trying to select a CPT^® code.