Neurosurgery Coding Alert

Question: Which code describes MRA of the cranium?

Nevada Subscriber Answer: CPT added two new codes to describe magnetic resonance angiography (MRA) of the cranium in 2001. These include 70544 (Magnetic resonance angiography, head; without contrast material[s]), 70545 (... with contrast material[s]) and 70546 (... without contrast material[s], followed by contrast material[s] and further sequences). You should select the appropriate code depending on whether the ordering physician specifies the use of contrast materials.

Be sure that you append modifier -26 (Professional component) for tests conducted on hospital or facility equipment. If the ordering physician owns the equipment on which the test occurs, you may report 70544/70545 with no modifiers attached.

Although MRA is gaining acceptance by payers throughout the country, the number of accepted diagnoses remains small. Common conditions in which MRAs are ordered include suspected nonruptured intracranial aneurysms (437.3, Cerebral aneurysm, nonruptured), arteriovenous malformations or AVM (447.0, Arterio-venous fistula, acquired), and carotid stenosis (433.10, Carotid stenosis, without mention of cerebral infarction).