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National Coverage Determination (NCD)

Magnetic Resonance Angiography

220.3

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Tracking Information

Publication Number
100-3
Manual Section Number
220.3
Manual Section Title
Magnetic Resonance Angiography
Version Number
2
Effective Date of this Version
07/01/2003
Ending Effective Date of this Version
04/10/2023
Implementation Date
07/01/2003
Implementation QR Modifier Date

Description Information

Benefit Category
Diagnostic Services in Outpatient Hospital
Diagnostic Tests (other)
Physicians' Services


Please Note: This may not be an exhaustive list of all applicable Medicare benefit categories for this item or service.

Item/Service Description
 
Indications and Limitations of Coverage
 
Cross Reference
Also see NCDs for Magnetic Resonance Imaging (§220.2) and Magnetic Resonance Spectroscopy (§220.2.1).

220.3 – Magnetic Resonance Angiography (MRA)

(replaced with section 220.2) (Rev. 123, Issued: 07-09-10, Effective: 06-03-10, Implementation: 08-09, 2010)
Claims Processing Instructions

Transmittal Information

Transmittal Number
123
Coverage Transmittal Link
https://www.cms.gov/Regulations-and-Guidance/Guidance/Transmittals/Downloads/R123NCD.pdf
Revision History

07/2010: 220.3 – Magnetic Resonance Angiography (MRA) (replaced with section 220.2)
(Rev. 123, Issued: 07-09-10, Effective: 06-03-10, Implementation: 08-09, 2010) (TN 123) (CR 7040)

09/2004 - Made clerical/technical edits/clarifications with no substantive revisions and no changes to existing NCD policy. Effective date NA. Implementation Date 09/10/2004. (TN 21) (CR 3425)

05/2003 - Expanded coverage for diagnosing pathology in renal or aortoiliac arteries. Effective and implementation dates 7/01/2003. (TN 170) (CR 2673)

06/1999 - Expanded coverage for diagnostic evaluation of abdomen and chest, specifically for preoperative evaluation and to determine extent of abdominal aortic aneurysm. Effective date 07/01/1999. (TN 117)

05/1997 - Clarified coverage of carotic vessels of head and neck, and expanded coverage for use in evaluating presence and extent of vascular disease in peripheral vessels of lower extremities. Effective date NA. (TN 99)

10/1995 - Provided limited coverage of MRA procedures. Effective date 10/01/1995. (TN 80)
Other

National Coverage Analyses (NCAs)

This NCD has been or is currently being reviewed under the National Coverage Determination process. The following are existing associations with NCAs, from the National Coverage Analyses database.

Coding Analyses for Labs (CALs)

This NCD has been or is currently being reviewed under the National Coverage Determination process. The following are existing associations with CALs, from the Coding Analyses for Labs database.

Additional Information

Other Versions
Title Version Effective Between
Magnetic Resonance Angiography - RETIRED 3 04/10/2023 - N/A View
Magnetic Resonance Angiography 2 07/01/2003 - 04/10/2023 You are here
Magnetic Resonance Angiography 1 07/01/1999 - 07/01/2003 View
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Reasons for Denial
Note: This section has not been negotiated by the Negotiated RuleMaking Committee. It includes CMS’s interpretation of it’s longstanding policies and is included for informational purposes. Tests for screening purposes that are performed in the absense of signs, symptoms, complaints, or personal history of disease or injury are not covered except as explicity authorized by statue. These include exams required by insurance companies, business establishments, government agencies, or other third parties. Tests that are not reasonable and necessary for the diagnosis or treatment of an illness or injury are not covered according to the statue. Failure to provide documentation of the medical necessity of tests may result in denial of claims. The documentation may include notes documenting relevant signs, symptoms, or abnormal findings that substantiate the medical necessity for ordering the tests. In addition, failure to provide independent verification that the test was ordered by the treating physician (or qualified nonphysician practitioner) through documentation in the physician’s office may result in denial. A claim for a test for which there is a national coverage or local medical review policy will be denied as not reasonable and necessary if it is submitted without an ICD-9-CM code or narrative diagnosis listed as covered in the policy unless other medical documentation justifying the necessity is submitted with the claim. If a national or local policy identifies a frequency expectation, a claim for a test that exceeds that expectation may be denied as not reasonable and necessary, unless it is submitted with documentation justifying increased frequency. Tests that are not ordered by a treating physician or other qualified treating nonphysician practitioner acting within the scope of their license and in compliance with Medicare requirements will be denied as not reasonable and necessary. Failure of the laboratory performing the test to have the appropriate Clinical Laboratory Improvement Act of 1988 (CLIA) certificate for the testing performed will result in denial of claims.
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