Appendix E - National Coverage Determinations Manual / MAGNETIC_RESONANCE_IMAGING

Why This Topic Matters

MRI and MRA are common advanced imaging services, and Medicare coverage depends on policy-specific clinical context, device status, and effective dates. Understanding this NCD helps reduce denials and supports compliant documentation and billing.

Article Sections

1. A. General

   Introduces MRI and MRA and summarizes broad imaging concepts, technology features, and general clinical utility. The section provides background on the modality and its relationship to other imaging approaches.

2. B. Nationally Covered MRI and MRA Indications

   Outlines the major categories of MRI and MRA services that may be covered under Medicare policy. The section is organized by clinical region and indication, with effective dates noted in the source.

3. 1. MRI

   Describes the principal categories of MRI coverage under the national policy. The content includes general covered uses and technology-related circumstances referenced by the manual.

4. 2. MRA (MRI for Blood Flow)

   Describes the covered categories of magnetic resonance angiography and the anatomic regions addressed by the policy. The content includes regional groupings and general circumstances for coverage.

5. a. Head and Neck

   Covers the head and neck category within MRA policy and identifies the kinds of vascular evaluation discussed for this region. It also addresses the broad clinical context for coverage review.

6. b. Peripheral Arteries of Lower Extremities

   Covers MRA policy for lower-extremity arterial evaluation. The section addresses coverage context for vascular imaging in this region.

7. c. Abdomen and Pelvis

   Covers MRA policy for abdominal and pelvic vascular and preoperative evaluation. The section is organized into specific subtopics involving major vascular territories and surgical planning.

8. d. Chest

   Covers chest MRA policy for selected cardiothoracic vascular conditions. The section is divided into diagnostic applications involving pulmonary and aortic evaluation.

9. C. Contraindications and Nationally Non-Covered Indications

   Summarizes circumstances in which MRI is not covered and the policy framework for exceptions. The section also discusses broader safety and research-related considerations tied to implanted devices and other patient-specific factors.

10. 1. Contraindications

    Describes the main contraindication category and the related coverage exception framework. The section includes device-related, pregnancy-related, and patient-safety considerations discussed in the policy.