Summary & Overview
CPT 0697T: Quantitative MRI Tissue Composition Analysis
CPT code 0697T covers MRI-based quantitative tissue composition analysis for multiple organs, including data acquisition, processing, transmission, and an interpretation with a report. This emerging imaging service captures advanced tissue metrics that can inform diagnosis, disease monitoring, and research. Nationally, the code is relevant as adoption of quantitative MRI techniques expands and payers evaluate coverage and reimbursement for image-derived biomarkers.
Key payers in the national discussion include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find an overview of what the code represents, how it is billed and categorized, and the clinical contexts where quantitative MRI is used. The publication outlines benchmark elements for utilization and payment (where available), summarizes recent policy and coding updates affecting adoption, and provides clinical context about when quantitative multi-organ MRI analyses are typically ordered.
This analysis is intended for billing managers, radiology administrators, and policy analysts who need a concise briefing on CPT code 0697T, its clinical purpose, typical sites of service, and the payer landscape shaping coverage decisions. Data not available in the input is noted where relevant.
Billing Code Overview
CPT code 0697T describes an MRI-based quantitative tissue composition analysis across multiple organs. The service includes acquiring MRI data, preparing and transmitting quantitative tissue composition datasets, and providing an interpretation with a formal report. This code represents an advanced imaging interpretation and data-processing service rather than simple image capture alone.
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Service type: Quantitative MRI analysis and interpretation
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Typical site of service: Hospital outpatient imaging centers or freestanding MRI facilities where advanced MRI acquisition and post-processing are performed
Clinical & Coding Specifications
Clinical Context
A typical patient is an adult referred by a hepatology or oncology clinic for quantitative MRI tissue composition analysis to evaluate organ fat fraction, iron content, or fibrosis staging across one or more organs (commonly liver, pancreas, spleen). The patient presents with metabolic syndrome, abnormal liver function tests, suspected hepatic steatosis, or monitoring after oncologic therapy. The clinical workflow: outpatient scheduling; pre-imaging assessment for MRI safety and contrast contraindications; MRI acquisition using specialized pulse sequences for quantitative mapping; technologist prepares and transmits raw quantitative maps to the interpreting radiologist or physicist; provider performs image post-processing, quantitative analysis, interpretation, and generates a formal report with quantitative metrics and clinical impressions. Results are routed to the referring clinician for longitudinal management or further diagnostic testing.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
26 | Professional component | Use when billing only the physician interpretation/report separate from technical imaging resources. |
TC | Technical component | Use when billing only the scanner, technologist, and image acquisition; facility bills technical component. |
52 | Reduced services | Use when the quantitative acquisition was partially performed or limited, producing reduced data sets. |
53 | Discontinued procedure | Use when the exam was started but terminated early for patient safety or intolerance. |
62 | Two surgeons | Use when two qualified physicians share primary surgical responsibility (rare for MRI but included if paired interventional procedure occurs). |
78 | Unplanned return to OR by same physician following initial procedure (related modifier) | Use only if an interventional complication required return to OR; rarely applicable. |
22 | Increased procedural services | Use when work, time, or complexity substantially exceeds typical for quantitative analysis and documentation supports increased work. |
26 | Professional component | Use when the reporting physician bills separately from the facility or equipment owner. |
QK | Medical direction of two or more qualified health care professionals | Use when the physician medically directs multiple allied health professionals during complex acquisition or post-processing. |
QX | Service performed by certified registered nurse anesthetist (CRNA) with physician absent | Use only if applicable anesthesia services are billed with this procedure. |
QY | Attending physician of record (QY) | Use when the physician is supervising clinical staff as designated by payor rules. |
| Taxonomy Code | Specialty | Notes |
|---|---|---|
| 207RC0000X | Diagnostic Radiology | Primary specialty performing MRI acquisition and interpretation for quantitative tissue mapping. |
| 2080P0206X | Nuclear Radiology / Neuroradiology (Quantitative Imaging Subspecialty) | Radiologists with quantitative imaging expertise who interpret tissue composition studies. |
| 207Q00000X | Radiology Assistant | Allied professional who may assist with acquisition and post-processing under supervision. |
| 2085R0202X | Gastroenterology | Referring specialty frequently ordering hepatic quantitative MRI for steatosis/iron/fibrosis assessment. |
| 207L00000X | Internal Medicine | Primary care or hepatology clinicians ordering and receiving results for metabolic liver disease monitoring. |
Related Diagnoses
| ICD-10 Code | Description | Clinical Relevance |
|---|---|---|
| Data not available in the input. | Data not available in the input. | Data not available in the input. |
Related CPT Codes
| CPT Code | Description | Relationship to This Procedure |
|---|---|---|
74183 | Magnetic resonance imaging, abdomen; without contrast material, for morphologic assessment | Often performed in conjunction when morphologic anatomic imaging is needed alongside quantitative tissue mapping of the liver or abdomen. |
74185 | Magnetic resonance imaging, abdomen; with contrast material(s) and without contrast material(s), followed by further sequences | Used when both contrast-enhanced anatomic evaluation and quantitative sequences are indicated in the same session. |
0159T | Magnetic resonance elastography (MRE) with interpretation and report | Alternative or complementary quantitative liver assessment technique for stiffness/fibrosis; may be ordered with 0697T for comprehensive tissue characterization. |
76376 | 3D rendering with interpretation and reporting of volumetric image data | May be performed if volumetric quantitation or advanced post-processing is required following acquisition of quantitative maps. |
70553 | MRI brain with and without contrast, for quantitative brain tissue composition | Representative quantitative MRI applications in other organ systems; similar workflow and coding considerations when brain quantitative analysis is performed. |