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Facilities across the U.S. have successfully implemented these codes and and have submitted successful reimbursement claims related to their use of icobrain.
Our dedicated reimbursement team is here to support your implementation every step of the way - with all the documentation, tools, and expertise you need:
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Coding and billing guide
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Letter of medical necessity
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Prior Authorization checklist
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Appeal letters
Over 30 U.S. insurers have processed claims using CPT-III® codes 0865T & 0866T for icobrain.
CPT is a registered trademark of the American Medical Association.
Copyright American Medical Association. All rights reserved.
What are the CPT-III ® codes 0865T and 0866T?
As of January 1, 2024, the new CPT® codes 0865T and 0866T, submitted by icometrix and approved by the American Medical Association (AMA) based on the extensive validation of icobrain, are officially active.
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The AMA and the American College of Radiology (ACR) published guidelines on using these codes for icometrix’s icobrain solution.
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0865T: Quantitative brain MRI analysis without diagnostic MRI in the same session, including comparison to prior studies, lesion detection, brain volume quantification, severity scoring, and reporting.
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0866T: Quantitative brain MRI analysis with diagnostic MRI in the same session, including the same elements as 0865T.
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icometrix is the first company to successfully submit and activate a CPT® III code in neuroradiology and the fifth to enable a CPT® III code in radiology software.
How to use the CPT® codes for icobrain?
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It is mentioned in the AMA article that our quantitative imaging analysis reported by code 0866T is used for patients with multiple sclerosis, Alzheimer's disease, traumatic brain injury, stroke, epilepsy, and Parkinson's disease. Subtle areas of abnormality that are not easily detected by the human eye are identified and compared with previous MR imaging to determine changes and disease progression.
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MRI brain and quantitative analyses by icobrain are commonly performed and reported on the same date of service. However, the physician may order icobrain to be performed during a separate session, such as using an MR scan performed on an earlier date.
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For the CPT® 2024 code set, the AMA’s CPT® Editorial Panel approved two new Category III codes (0865T, 0866T) for icobrain. Please contact our icometrix team for any questions on this CPT® code and if we can help your hospital start implementing these new codes.
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The article describes a case of a person with a history of demyelinating disease, who was referred by a neurologist for a brain MRI examination, including quantitative MRI assessment by icobrain. For such a case, after January 1, 2024, it is appropriate to report code 70553 for the brain MRI with and without contrast and add-on code 0866T for icobrain.
It’s rare to see an AI-powered neuroimaging solution get a CPT-III code that is already being considered for reimbursement by multiple payers. But thanks to our rigorous validation, a CPT-III® code has now been assigned for icobrain, supporting reimbursement consideration across multiple insurers.
It’s rare to see an AI-powered neuroimaging solution get a CPT-III code that is already being considered for reimbursement by multiple payers. But thanks to our rigorous validation, a CPT-III® code has now been assigned for icobrain, supporting reimbursement consideration across multiple insurers.
Dirk Smeets, PhD
CTO at icometrix
