Radiology Coding Alert

Question: Which code describes MRA of the cranium? We're having trouble getting reimbursed for this procedure.


Florida Subscriber

Answer: CPT Codes 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 interpreting physician owns the equipment on which the test is performed, you may report 70544-70546 with no modifiers attached.

Although MRA is gaining acceptance by payers throughout the country, the number of accepted diagnoses remains small. Common conditions for which MRA of the head is ordered include nonruptured intracranial aneurysms (437.3, Cerebral aneurysm, nonruptured), arteriovenous malformations or AVM (depending on your payer you may be able to report 747.81, Other specified anomalies of circulatory system; anomalies of cerebrovascular system or 447.0, Arteriovenous fistula, acquired), and carotid stenosis (433.10, Carotid stenosis, without mention of cerebral infarction).