National_Coverage_Determinations_Manual / MAGNETIC_RESONANCE_IMAGING

Why This Topic Matters

MRI and MRA coverage depends on the specific clinical scenario and policy limitations, so this guidance helps readers determine whether a case falls within Medicare’s nationally covered categories or a contraindicated/non-covered category.

Article Sections

1. A. General

   Introduces MRI and MRA at a high level and describes the imaging concepts and modalities discussed in the policy. It also outlines general clinical utility and the broad technical context for the coverage guidance.

2. B. Nationally Covered MRI and MRA Indications

   Summarizes the main categories of MRI and MRA indications addressed by the policy. The section is organized by modality and by anatomical or clinical area.

3. 1. MRI

   Covers the general body areas and clinical situations described as nationally covered for MRI. It also notes effective dates and technical circumstances associated with coverage.

4. 2. MRA (MRI for Blood Flow)

   Describes the overall categories of MRA coverage and the broad vascular territories referenced in the policy. It introduces the anatomic subsections that follow.

5. a. Head and Neck

   Addresses coverage considerations for MRA in head-and-neck vascular evaluation. The section discusses the clinical setting and the types of vascular territories referenced.

6. b. Peripheral Arteries of Lower Extremities

   Discusses MRA coverage for peripheral arterial evaluation in the lower extremities. The section describes the general clinical scenarios included in the policy.

7. c. Abdomen and Pelvis

   Covers abdominal and pelvic MRA indications and the related vascular or pre-operative contexts. The section is divided into specific clinical use categories.

8. i. Pre-operative Evaluation of Patients Undergoing Elective Abdominal Aortic Aneurysm (AAA) Repair

   Addresses pre-operative abdominal and pelvic vascular imaging in the setting of elective aneurysm repair. It places this use within the broader policy framework for abdominal aortic evaluation.

9. ii. Imaging the Renal Arteries and the Aortoiliac Arteries in the Absence of AAA or Aortic Dissection

   Describes coverage expansion for selected abdominal and pelvic vascular imaging scenarios when certain major conditions are absent. It focuses on the general management context for this imaging use.

10. d. Chest

    Covers chest MRA applications discussed in the policy. The section is subdivided into specific thoracic diagnostic scenarios.

11. i. Diagnosis of Pulmonary Embolism

    Addresses the chest imaging context for suspected pulmonary embolism. The section explains the broader diagnostic setting in which this MRA use is discussed.

12. ii. Evaluation of Thoracic Aortic Dissection and Aneurysm

    Discusses thoracic aortic imaging coverage in the pre-operative and post-operative setting. It also references comparison with other diagnostic approaches at a general level.

13. C. Contraindications and Nationally Non-Covered Indications

    Summarizes circumstances in which MRI is not covered or is limited by contraindications. The section also includes the implanted-device clinical-study coverage framework and other non-covered situations.

14. 1. Contraindications

    Lists patient-specific situations and broader factors that affect MRI coverage or appropriateness. It includes the policy’s discussion of special coverage conditions for certain implanted-device cases and other exclusions.