MRA Now Covered (or not) Under MRI NCD

The Centers for Medicare & Medicaid Services (CMS) has merged the magnetic resonance angiography (MRA) national coverage determination (NCD) into the magnetic resonance imaging (MRI) NCD. The effect of this change maintains existing national coverage for both MRI and MRA, and eliminates the non-coverage language for MRA. Effective for claims with service dates on or after June 3, Medicare contractors now have the discretion to cover or not cover all indications of MRA that are not specifically nationally covered or non-covered.

MRA is a non-invasive diagnostic test that is an application of MRI. By analyzing the amount of energy released from tissues exposed to a strong magnetic field, MRA provides images of normal and diseased blood vessels, as well as visualization and quantification of blood flow through these vessels.

Currently covered indications include using MRA for specific conditions to evaluate flow in internal carotid vessels of the head and neck, peripheral arteries of lower extremities, abdomen and pelvis, and the chest.

See CMS Transmittal 123 for claims processing instructions in Pub. 100-03, NCD Manual, section 220.2, for the MRA (and MRI) coverage policy, and Pub. 100-04, Claims Processing Manual, chapter 13, section 40.1.

Source: CMS Transmittal 1998, Change Request (CR) 7040, issued July 9.


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