C8904

Notice

• HCPCS C8904 terminated on December 31, 2018.

Short Description

• Mri w/o cont, breast, uni

HCPCS Coverage Code

• D = Special coverage instructions apply

HCPCS Action Code

• N = No maintenance for this code

HCPCS Action Effective Date

• January 01, 2019

HCPCS Code Added Date

• October 01, 2001

HCPCS Termination Date

• December 31, 2018

HCPCS Pricing Indicator Code

• 53 = Statute

HCPCS Multiple Pricing Indicator Code

• A = Not applicable as HCPCS priced under one methodology

HCPCS Statute Number

• 1833(t)(2)

HCPCS Cross Reference Code

• 77046

HCPCS Type Of Service Code

• 4 = Diagnostic radiology

HCPCS Anesthesia Base Unit Quantity

• 0