Medicare expands MR angiography coverage

The Health Care Financing Administration has adopted a new national policy that substantially expands Medicare Part B coverage for magnetic resonance angiography.

As of May 1, the federal healthcare insurance program began to routinely pay for lower extremity peripheral vascular MRA and MRA of the external carotid arteries. The policy directive applies to all outpatient MRI services that serve Medicare patients across the country, according to a HCFA spokesperson. It replaces an October 1995 directive that covered head and neck indications of MRA only when conventional x-ray angiography was contraindicated (SCAN 10/25/95).

Under the new policy, radiologists are no longer required to document that the patient is allergic to contrast media before performing MRA, according to a HCFA policy analyst. The policy directive advises carriers that MRA is appropriate after a positive ultrasound test for patients with carotid stenosis. MRA may be used as an adjunct to x-ray angiography only when ultrasound and MRA results are incongruent or inconclusive.

HCFA also gave physicians the green light for MRA or contrast angiography in cases of suspected peripheral vascular disease in the lower extremities. Reimbursement for both techniques will be granted when the results of x-ray angiography do not disclose a viable run-off vessel for surgical bypass or when MRA results are inconclusive.