HCPCS C8908: MRI w/o contrast followed by w/ contrast, breast

Learn how to use and bill HCPCS code C8908 for bilateral breast MRI without and with contrast under the Hospital Outpatient Prospective Payment System (OPPS).

Use Code

Frequently asked questions

C8908 is a temporary HCPCS Level II code (a "C" code). These codes are managed by CMS and are primarily used for procedures paid under the OPPS.

For Medicare, while the code is used for billing, Medicare coverage rules depend on the medical necessity criteria outlined in National and Local Coverage Determinations (NCDs/LCDs). For private payers, breast MRI is frequently subject to prior authorization or pre-certification requirements based on the payer's clinical appropriateness guidelines.

Yes, if the patient meets high-risk criteria defined by Medicare or the specific payer's medical policy, the procedure may be covered for screening. In such cases, the diagnosis code Z12.31 (Encounter for screening mammogram for malignant neoplasm of breast) or a more specific high-risk code (like a confirmed gene mutation) should be reported.