Cardiac MRI May Be Covered, May Not
- By admin aapc
- In CMS
- November 2, 2009
- Comments Off on Cardiac MRI May Be Covered, May Not
The Centers for Medicare & Medicaid Services (CMS) has determined that its blanket of non-coverage for blood flow measurement using magnetic resonance imaging (MRI) technology contradicts its policies and magnetic resonance angiography (MRA). CMS has eliminated that from the national coverage determination (NCD), effective Sept. 28, and is allowing payers to choose to cover the services. This will impact four codes in January’s outpatient code editor (OCE).
The 2009 codes which are changing from non-covered to covered and will appear in the January 2010 OCE are as follows:
|
75558 |
Cardiac magnetic resonance imaging for morphology and function without contrast material; with flow/velocity quantification |
|
75560 |
Cardiac magnetic resonance imaging for morphology and function without contrast material; with flow/velocity quantification and stress |
|
75562 |
Cardiac magnetic resonance imaging for morphology and function without contrast material(s), followed by contrast material(s) and further sequences; with flow/velocity quantification |
|
75564 |
Cardiac magnetic resonance imaging for morphology and function without contrast material(s), followed by contrast material(s) and further sequences; with flow/velocity quantification and stress |
Note: Your Medicare contractor will not search for previously-processed claims with service dates of Sept. 28 through Dec. 31, but will adjust any claims that you bring to their attention.
All other uses of MRI noted in Pub. 100-03, NCD Manual, section 220.2 remain unchanged. If you would like to know more, check out CMS transmittal 107, issued Oct. 16.
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