Clinical functional magnetic resonance imaging.

Area of Science:

• Neuroimaging
• Medical Billing
• Clinical Psychology

Background:

• Functional magnetic resonance imaging (fMRI) is an advanced neuroimaging technique.
• As of January 2007, three distinct CPT codes were available for fMRI billing.
• Accurate billing is crucial for the adoption and accessibility of new medical procedures.

Purpose of the Study:

• To introduce and describe new Current Procedural Terminology (CPT) codes.
• These codes were approved by the American Medical Association (AMA) CPT Editorial Panel.
• The codes facilitate billing for fMRI procedures by physicians and licensed clinical psychologists.

Main Methods:

• Description of newly approved CPT codes for fMRI.
• Identification of codes for imaging and neurofunctional components.
• Clarification of code usage based on administration requirements.

Main Results:

• CPT code 70554: MRI, brain, fMRI; including test selection and administration of repetitive body part movement and/or visual stimulation, not requiring physician or psychologist administration.
• CPT code 70555: MRI, brain, fMRI; requiring physician or psychologist administration.
• CPT code 96020: neurofunctional testing selection and administration during noninvasive imaging functional brain mapping, with test administered entirely by a physician or psychologist, with review of test results and report.

Conclusions:

• New CPT codes enable billing for both the neurofunctional and imaging aspects of fMRI.
• This facilitates the use of fMRI as an activation study for neurofunctional ability localization.
• Improved billing processes support the clinical application of advanced brain mapping techniques.