CPT 0649T: MRI Quantitative Tissue Composition Analysis, Single Organ

CPT code 0649T represents an MRI-based quantitative tissue composition analysis limited to a single organ and includes data acquisition, preparation, transmission, interpretation, and reporting. As an add-on to a diagnostic MRI of the same anatomy, this code captures advanced imaging analytics that supplement standard diagnostic MRI studies. Nationally, the code matters because it documents and differentiates advanced post-processing and interpretation services that may affect coding practices, claims processing, and imaging utilization patterns.

Key payers covered in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find benchmarks and comparisons for coverage and payment approaches across major national payers where available, summaries of coding and clinical context for integrating the service with diagnostic MRI, and notes on common modifier use and billing adjacencies. The publication also outlines the clinical rationale for single-organ quantitative tissue assessment using MRI and explains typical settings where the service is performed, such as hospital outpatient imaging centers and freestanding MRI facilities.

This resource is intended to give billing managers, clinical leaders, and policy analysts a concise overview of what CPT code 0649T denotes, how it is positioned relative to diagnostic MRI, and what topics — including payer coverage patterns, coding considerations, and clinical applications — are addressed in the full report. Data not available in the input will be noted where applicable.

Billing Code Overview

CPT code 0649T describes an MRI-based quantitative tissue composition analysis limited to a single organ. The service includes acquisition, preparation, transmission of data, and a professional interpretation with report. This add-on service is performed in conjunction with a diagnostic MRI of the same anatomy.

Service type: Advanced MRI quantitative analysis

Typical site of service: Hospital outpatient imaging centers or freestanding MRI facilities

Data not available in the input.

Clinical Context

A 58-year-old patient with known nonalcoholic fatty liver disease (NAFLD) and progressive transaminase elevation is referred for advanced MRI tissue composition analysis of the liver to quantify fat fraction and fibrosis biomarkers. The patient presents to an outpatient radiology center on the same day as a diagnostic liver MRI. The technologist performs the diagnostic MRI sequences first, followed by acquisition of the quantitative tissue composition protocol targeted to the liver. The imaging data are processed and transmitted to the interpreting radiologist, who performs a formal interpretation and generates a report documenting quantitative fat fraction, iron quantification if applicable, and supportive tissue characterization metrics. The quantitative analysis represented by 0649T is billed as an add-on to the diagnostic MRI of the same anatomy. Typical workflow steps: scheduling and preauthorization, standard MRI safety screening, diagnostic MRI acquisition, additional quantitative acquisition for 0649T, image post-processing, radiologist interpretation and report, and transmission of images and report to the referring clinician.

Coding Specifications

Modifier	Description	When to Use
`26`	Professional component	When reporting only the professional component (interpretation) separate from technical facility services.

Taxonomy Code	Specialty	Notes
`2085R0200X`	Diagnostic Radiology	Radiologists performing MRI interpretation and quantitative tissue analysis.
`207RC0000X`	Radiology Assistant	Radiology assistants or advanced imaging specialists involved in acquisition or QA.
`363A00000X`	Hospitalist (Imaging-related coordination)	Clinicians coordinating inpatient imaging and follow-up results.
`2084P0800X`	Neuroradiology	When the quantitative technique is applied to brain tissue composition studies (single-organ variation).
`207L00000X`	Nuclear Medicine	Applicable when PET/MR hybrid workflows or quantitative imaging specialists collaborate.

Related Diagnoses

ICD-10 Code	Description	Clinical Relevance
`K76.0`	Fatty (change of) liver, not elsewhere classified	Quantitative MRI assesses hepatic steatosis and fat fraction.
`K74.60`	Unspecified cirrhosis of liver	Tissue composition MRI can provide biomarkers of fibrosis severity to supplement clinical staging.
`K70.30`	Alcoholic cirrhosis of liver without ascites	Quantitative imaging may be used to assess structural and compositional liver changes.
`R74.0`	Nonspecific elevation of levels of transaminase and lactic acid dehydrogenase	Used when lab abnormalities prompt quantitative liver MRI for tissue characterization.
`E78.5`	Hyperlipidemia, unspecified	Metabolic risk factor associated with hepatic steatosis; supports use of quantitative liver MRI.

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`74181`	Magnetic resonance (e.g., proton density, T1, T2), abdomen and pelvis without contrast	Diagnostic MRI of the abdomen that would be performed on the same anatomy as `0649T` when evaluating liver disease.
`74183`	Magnetic resonance, abdomen and pelvis with and without contrast	Diagnostic MRI examining both pre- and post-contrast sequences; `0649T` is an add-on quantitative analysis to these diagnostic studies.
`0174T`	MRI guidance for percutaneous biopsy, imaging, and targeting (example code for MRI guidance)	Performed when MR-guided intervention or biopsy follows quantitative assessment; supports targeted sampling when needed.
`0159T`	MRI elastography, liver (when applicable — example code historically used for MR elastography)	Commonly paired with quantitative tissue composition to assess fibrosis; coded separately when performed.
`76145`	Magnetic resonance image post-processing, for example, for quantification, when reported separately	Represents additional post-processing work that complements `0649T` when separate post-processing billing is appropriate.

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Summary & Overview