| Section | B | Imaging |
| Body System | H | Skin, Subcutaneous Tissue and Breast |
| Type | 3 | Magnetic Resonance Imaging (MRI): Computer reformatted digital display of multiplanar images developed from the capture of radiofrequency signals emitted by nuclei in a body site excited within a magnetic field |
| Body Part 0 Breast, Right 1 Breast, Left 2 Breasts, Bilateral D Subcutaneous Tissue, Head/Neck F Subcutaneous Tissue, Upper Extremity G Subcutaneous Tissue, Thorax H Subcutaneous Tissue, Abdomen and Pelvis J Subcutaneous Tissue, Lower Extremity |
Contrast Y Other Contrast |
Qualifier 0 Unenhanced and Enhanced Z None |
Qualifier Z None |
| Body Part 0 Breast, Right 1 Breast, Left 2 Breasts, Bilateral D Subcutaneous Tissue, Head/Neck F Subcutaneous Tissue, Upper Extremity G Subcutaneous Tissue, Thorax H Subcutaneous Tissue, Abdomen and Pelvis J Subcutaneous Tissue, Lower Extremity |
Contrast Z None |
Qualifier Z None |
Qualifier Z None |