Summary & Overview
HCPCS Level II C8907: Magnetic Resonance Imaging Without Contrast, Breast; Bilateral
HCPCS Level II code C8907 denotes bilateral magnetic resonance imaging of the breasts performed without intravenous contrast. This imaging procedure provides high-resolution anatomic detail for bilateral breast evaluation and is used in diagnostic workflows where non-contrast MRI is indicated. Nationally, breast MRI utilization, coding, and coverage policies affect access to advanced imaging for screening, diagnostic clarification, and preoperative planning.
Key payers included in the analysis are Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise overview of clinical context for bilateral non-contrast breast MRI, typical sites of service, and the payer landscape that influences coverage and billing practices. The publication summarizes common modifiers and notes where data from input is not available.
The article provides benchmark-oriented context, coding specifics for C8907, and guidance on what documentation elements commonly accompany breast MRI claims. It also outlines where additional policy detail or payer-specific coverage rules would normally be consulted. Data not available in the input is explicitly noted where relevant.
Billing Code Overview
HCPCS Level II code C8907 represents magnetic resonance imaging without contrast of both breasts. The service is an imaging study intended to capture detailed breast anatomy bilaterally using non-contrast MRI techniques.
Typical site of service: outpatient imaging center or hospital outpatient department where MRI equipment and radiology interpretation are available.
Clinical & Coding Specifications
Clinical Context
A typical patient is a woman referred for imaging evaluation of the breasts using magnetic resonance imaging without contrast, bilateral (C8907). Common indications include high-risk screening (personal or strong family history of breast cancer, known BRCA1/BRCA2 mutation), problem-solving when mammography and ultrasound are inconclusive, preoperative assessment of known unilateral or bilateral breast cancer to evaluate extent of disease, and evaluation of implant integrity when non-contrast assessment is sufficient. The clinical workflow begins with an order from the referring clinician documenting the indication and relevant history. The patient is screened for MRI safety (implants, devices, pregnancy), positioned prone in a dedicated breast coil, and scanned with a standardized non-contrast breast MRI protocol that acquires high-resolution bilateral images. Images are reviewed by a fellowship-trained breast radiologist who issues a diagnostic report with findings and recommendations for further imaging, biopsy, or surgical planning as indicated. Image post-processing and archiving are performed, and the referring provider receives the final report for ongoing management. Modifier 51 may be appended when multiple procedures are billed during the same encounter and reduction of payment for multiple surgical procedures is applicable, per payer rules.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
51 |