Don't have a TCI SuperCoder account yet? Become a Member >>

Radiology Coding Alert

You Be the Coder:

MRA of the Cranium

Question: How is magnetic resonance angiography (MRA) of the cranium coded?

Pamela Jones
Springfield, Mo.

Test your coding knowledge. Determine how you would code this situation before looking at the box below for the answer.

  Answer: According to CPT Codes 2000, the correct code for this procedure would be 70541 (magnetic resonance angiography, head and/or neck, with or without contrast material[s]). This code has been deleted from CPT 2001, however. The new codes are 70544 (magnetic resonance angiography, head; without contrast material[s]), CPT 70545 (... with contrast material[s]) and 70546 (... without contrast material[s], followed by contrast material[s] and further sequences). Coders should select the appropriate code based on the use of contrast.

MRA is a noninvasive diagnostic procedure that has been used for many years to evaluate the blood flow in internal carotid vessels located in the head and neck, including the circle of Willis; the anterior, middle or posterior cerebral arteries; the vertebral or basilar arteries; and the venous sinuses. The procedure is most often performed on patients with conditions of the head and neck for which surgery is anticipated, including tumors, aneurysms, vascular malformations, vascular occlusions or thrombosis.

Although MRA is gaining acceptance by payers throughout the country, reimbursement policies are narrowly defined, and coding professionals must keep abreast of limitations and restrictions placed upon its use by local Medicare carriers. Common conditions where MRA may be ordered include suspected non-ruptured intracranial aneurysms (i.e., 437.3, cerebral aneurysm, nonruptured), arteriovenous malformations or AVM (i.e., 447.0, arteriovenous fistula, acquired) and carotid stenosis (433.10, carotid stenosis, without mention of cerebral infarction).

Answer for You Be the Coder provided by Scott Roberson, CPC, CPC-H, APC, senior compliance coding consultant at Intermountain Health Care, a multispecialty practice in Salt Lake City.