Summary & Overview
CPT 70559: Intraoperative Brain MRI With and Without Contrast
CPT code 70559 designates intraoperative magnetic resonance imaging (MRI) of the brain, including the brain stem and skull base, performed during open cranial surgery. This code captures a two-part imaging sequence performed during the same operative encounter: initial imaging without contrast followed by repeat imaging with contrast, intended to evaluate residual tumor or vascular malformation. The code is clinically significant because intraoperative MRI can directly affect surgical decision-making, extent of resection, and immediate identification of residual pathology.
Key national payers typically addressed in coverage and payment policies include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise presentation of clinical context, typical site-of-service considerations (operating room/intraoperative setting), common modifiers used with the code, and a summary of what to expect in payer policy and billing workflows. Where available, the publication provides benchmarks for utilization and reimbursement trends and highlights policy updates that influence intraoperative imaging services.
This summary equips clinicians, billing professionals, and policy analysts with a clear definition of the service represented by 70559, the operational setting in which it is used, and the payer environment most relevant to national billing and coverage considerations. Data not available in the input is identified and omitted from the narrative.
Billing Code Overview
CPT code 70559 describes intraoperative magnetic resonance imaging (MRI) of the brain, including the brain stem and skull base, performed during open cranial surgery. The procedure is conducted first without contrast material and then repeated with contrast to obtain additional images for assessment of residual tumor or residual vascular malformation.
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Service type: Intraoperative diagnostic imaging (intraoperative brain MRI)
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Typical site of service: Operating room during open brain surgery (intraoperative setting)
Clinical & Coding Specifications
Clinical Context
A 54-year-old patient undergoing craniotomy for resection of a suspected intracranial neoplasm presents intraoperatively for assessment of residual tumor. After initial microsurgical resection, the surgical team requests intraoperative MRI to evaluate the resection cavity and adjacent brain stem and skull base structures. The radiology team brings an MRI-compatible head coil into the operating room; imaging is performed first without intravenous contrast to evaluate resection margins and blood products, then repeated with gadolinium-based contrast to better delineate any enhancing residual tumor or vascular malformation. Images are reviewed immediately by the neuroradiologist and neurosurgeon to determine whether additional resection is required. Typical workflow includes intraoperative anesthesia management, MRI technologist setup, neuroradiology interpretation, and documentation of findings in the operative record. The typical site of service is the operating room (intraoperative/imaging performed during an open cranial procedure). The service type is intraoperative magnetic resonance imaging of the brain with and without contrast to assess for residual tumor or vascular malformation.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
62 | Two surgeons | Use when two surgeons work together as primary surgeons during the procedure and documentation supports two distinct surgeon roles. |