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Magnetic resonance angiography (MRA) is a specialized imaging technique that focuses on the spinal canal and its contents, utilizing either contrast material or performing the procedure without it. This noninvasive diagnostic radiology procedure employs a powerful magnetic field combined with radiofrequency energy to generate detailed images of blood vessels. The primary purpose of conducting an MRA of the spinal canal is to evaluate potential vascular abnormalities or lesions affecting the spinal cord. Such conditions may include dural arteriovenous fistulas, which are abnormal connections between arteries and veins, and intramedullary glomus type arteriovenous malformations, which are complex vascular structures within the spinal cord. During the procedure, multiple images are captured, typically with a thickness of 1-2mm, and these images are subsequently processed to create maximum intensity projections (MIPs). MIPs are akin to subtraction angiograms, allowing for enhanced visualization of the vascular structures. The radiologist identifies specific areas of interest within the images, which are then coned down to produce more detailed views of the blood vessels. This image post-processing is carried out by a technologist, while the radiologist reviews both the MIPs and the initial MRA images to compile a comprehensive written report of the findings. In certain cases, an intravenous line may be established to administer contrast dye, which aids in improving the clarity and detail of the images obtained during the procedure.
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Magnetic resonance angiography (MRA) of the spinal canal and contents is indicated for the evaluation of various vascular conditions and abnormalities. The following are specific indications for performing this procedure:
The procedure for magnetic resonance angiography of the spinal canal involves several key steps to ensure accurate imaging and assessment of vascular structures. The following outlines the procedural steps:
After the magnetic resonance angiography procedure, patients are typically monitored for a short period, especially if contrast material was administered. They may be advised to hydrate adequately to help flush the contrast dye from their system. The radiologist's report will be made available to the referring physician, who will discuss the findings with the patient and determine any necessary follow-up actions or treatments based on the results of the MRA. Patients are generally able to resume normal activities shortly after the procedure, unless otherwise instructed by their healthcare provider.
| Short Descr | MR ANGIO SPINE W/O&W/DYE | Medium Descr | MRA SPINAL CANAL W/WO CONTRAST MATERIAL | Long Descr | Magnetic resonance angiography, spinal canal and contents, with or without contrast material(s) | Status Code | Restricted Coverage | Global Days | XXX - Global Concept Does Not Apply | PC/TC Indicator (26, TC) | 1 - Diagnostic Tests for Radiology Services | Multiple Procedures (51) | 4 - Special payment adjustment rules on the technical component (TC) of multiple diagnostic imaging procedures apply... | Bilateral Surgery (50) | 0 - 150% payment adjustment for bilateral procedures does NOT apply. | Physician Supervisions | 09 - Concept does not apply. | Assistant Surgeon (80, 82) | 9 - Concept does not apply. | Co-Surgeons (62) | 0 - Co-surgeons not permitted for this procedure. | Team Surgery (66) | 0 - Team surgeons not permitted for this procedure. | Diagnostic Imaging Family | 88 - | APC Status Indicator | Code Not Recognized by OPPS when submitted on Outpatient Hospital Part B Bill Type (12x/13x) | Type of Service (TOS) | 4 - Diagnostic Radiology | Berenson-Eggers TOS (BETOS) | I2D - Advanced imaging - MRI/MRA: other | MUE | 1 | CCS Clinical Classification | 198 - Magnetic resonance imaging |
| 26 | Professional component: certain procedures are a combination of a physician or other qualified health care professional component and a technical component. when the physician or other qualified health care professional component is reported separately, the service may be identified by adding modifier 26 to the usual procedure number. | GC | This service has been performed in part by a resident under the direction of a teaching physician | 51 | Multiple procedures: when multiple procedures, other than e/m services, physical medicine and rehabilitation services or provision of supplies (eg, vaccines), are performed at the same session by the same individual, the primary procedure or service may be reported as listed. the additional procedure(s) or service(s) may be identified by appending modifier 51 to the additional procedure or service code(s). note: this modifier should not be appended to designated "add-on" codes (see appendix d). | 52 | Reduced services: under certain circumstances a service or procedure is partially reduced or eliminated at the discretion of the physician or other qualified health care professional. under these circumstances the service provided can be identified by its usual procedure number and the addition of modifier 52, signifying that the service is reduced. this provides a means of reporting reduced services without disturbing the identification of the basic service. note: for hospital outpatient reporting of a previously scheduled procedure/service that is partially reduced or cancelled as a result of extenuating circumstances or those that threaten the well-being of the patient prior to or after administration of anesthesia, see modifiers 73 and 74 (see modifiers approved for asc hospital outpatient use). | 59 | Distinct procedural service: under certain circumstances, it may be necessary to indicate that a procedure or service was distinct or independent from other non-e/m services performed on the same day. modifier 59 is used to identify procedures/services, other than e/m services, that are not normally reported together, but are appropriate under the circumstances. documentation must support a different session, different procedure or surgery, different site or organ system, separate incision/excision, separate lesion, or separate injury (or area of injury in extensive injuries) not ordinarily encountered or performed on the same day by the same individual. however, when another already established modifier is appropriate it should be used rather than modifier 59. only if no more descriptive modifier is available, and the use of modifier 59 best explains the circumstances, should modifier 59 be used. note: modifier 59 should not be appended to an e/m service. to report a separate and distinct e/m service with a non-e/m service performed on the same date, see modifier 25. | 76 | Repeat procedure or service by same physician or other qualified health care professional: it may be necessary to indicate that a procedure or service was repeated by the same physician or other qualified health care professional subsequent to the original procedure or service. this circumstance may be reported by adding modifier 76 to the repeated procedure or service. note: this modifier should not be appended to an e/m service. | 77 | Repeat procedure by another physician or other qualified health care professional: it may be necessary to indicate that a basic procedure or service was repeated by another physician or other qualified health care professional subsequent to the original procedure or service. this circumstance may be reported by adding modifier 77 to the repeated procedure or service. note: this modifier should not be appended to an e/m service. | GA | Waiver of liability statement issued as required by payer policy, individual case | GZ | Item or service expected to be denied as not reasonable and necessary | MF | The order for this service does not adhere to the appropriate use criteria in the clinical decision support mechanism consulted by the ordering professional | MG | The order for this service does not have applicable appropriate use criteria in the qualified clinical decision support mechanism consulted by the ordering professional | MH | Unknown if ordering professional consulted a clinical decision support mechanism for this service, related information was not provided to the furnishing professional or provider | TC | Technical component; under certain circumstances, a charge may be made for the technical component alone; under those circumstances the technical component charge is identified by adding modifier 'tc' to the usual procedure number; technical component charges are institutional charges and not billed separately by physicians; however, portable x-ray suppliers only bill for technical component and should utilize modifier tc; the charge data from portable x-ray suppliers will then be used to build customary and prevailing profiles | X5 | Diagnostic services requested by another clinician: for reporting services by a clinician who furnishes care to the patient only as requested by another clinician or subsequent and related services requested by another clinician; this modifier is reported for patient relationships that may not be adequately captured by the above alternative categories; reporting clinician service examples include but are not limited to, the radiologist's interpretation of an imaging study requested by another clinician | XE | Separate encounter, a service that is distinct because it occurred during a separate encounter | XU | Unusual non-overlapping service, the use of a service that is distinct because it does not overlap usual components of the main service |
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| 1994-01-01 | Added | First appearance in code book in 1994. |
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