| HCPCS Code: |
C8904 |
| Long Description: |
Magnetic resonance imaging without contrast, breast; unilateral |
| Short Description: |
Mri w/o cont, breast, uni |
| Pricing Indicator 1: |
53 (Statute) |
| Multiple Pricing Code: |
A (Not applicable as HCPCS priced under one methodology) |
| Statute Number: |
1833(t)(2) |
| Coverage Code: |
D (Special coverage instructions apply) |
| ASC Payment Group Code: |
YY |
| ASC Payment Group Date: |
01-01-2008 |
| Processing Note Number: |
|
| Berenson-Eggers Type of Service (BETOS) Code: |
I2D (Advanced imaging - MRI: other) |
| Type of Service Code 1: |
4 (Diagnostic radiology) |
| Anesthesia Base Unit Quality: |
0 |
| Code Added: |
01-10-2001 |
| Action Effective Date: |
01-10-2001 |
| Action Code: |
N (No maintenance for this code) |
