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Official Description

Magnetic resonance angiography, pelvis, with or without contrast material(s)

© Copyright 2025 American Medical Association. All rights reserved.

Common Language Description

Magnetic resonance angiography (MRA) is a specialized imaging technique that focuses on visualizing the blood vessels within the pelvis. This noninvasive procedure utilizes a powerful magnetic field combined with radio wave energy to generate detailed images of vascular structures. The primary purpose of MRA is to identify and assess various vascular conditions, including narrowed or obstructed arteries, the presence of venous blood clots, and the extent of atherosclerosis, which can lead to ischemic areas. Additionally, MRA of the pelvis is instrumental in evaluating blood flow from the hips, particularly in patients experiencing claudication, a condition characterized by pain in the legs due to inadequate blood supply. During the procedure, multiple images are captured, typically ranging from 1 to 2 millimeters in thickness. These images are then processed to create maximum intensity projections (MIPs), which provide a visual representation akin to subtraction angiograms. The radiologist plays a crucial role in identifying areas of interest within the images, which are subsequently refined to yield detailed views of the blood vessels. The image processing is conducted 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 some cases, an intravenous line may be established to administer contrast dye, enhancing the clarity and detail of the vascular images obtained during the procedure.

© Copyright 2025 Coding Ahead. All rights reserved.

1. Indications

Magnetic resonance angiography of the pelvis is indicated for a variety of vascular conditions and symptoms that necessitate detailed imaging of the blood vessels. The following are the primary indications for this procedure:

  • Narrowed or Blocked Arteries - MRA is performed to assess the presence and extent of arterial stenosis, which can impede blood flow.
  • Venous Blood Clots - The procedure is utilized to detect thrombosis in the pelvic veins, which can lead to serious complications if left untreated.
  • Atherosclerosis - MRA helps evaluate the severity and distribution of atherosclerotic changes in the pelvic vasculature.
  • Ischemic Areas - The imaging technique is used to identify regions of the pelvis that are experiencing reduced blood supply due to vascular issues.
  • Claudication in the Legs - MRA is indicated for patients presenting with leg pain during physical activity, which may be due to inadequate blood flow from the hips.

2. Procedure

The procedure for magnetic resonance angiography of the pelvis involves several key steps to ensure accurate imaging and assessment of the vascular structures. The following outlines the procedural steps:

  • Patient Preparation - Prior to the MRA, the patient is prepared by explaining the procedure, obtaining informed consent, and ensuring that any contraindications to MRI, such as certain implants or devices, are addressed. The patient may be asked to change into a gown and remove any metallic objects.
  • Positioning - The patient is positioned on the MRI table, typically lying flat on their back. Proper alignment is crucial to obtain clear images of the pelvic region.
  • Image Acquisition - The MRI machine is activated, and the imaging process begins. High-powered magnetic fields and radio waves are utilized to capture multiple images of the pelvic blood vessels. These images are taken in thin slices, usually 1-2 mm thick, to ensure detailed visualization.
  • Contrast Administration (if applicable) - If contrast material is indicated, an intravenous line is established, and contrast dye is administered to enhance the visibility of the blood vessels. This step is crucial for improving the diagnostic quality of the images.
  • Image Processing - After the images are acquired, they are processed to create maximum intensity projections (MIPs). This post-processing is performed by a technologist, who refines the images to highlight areas of interest.
  • Radiologist Review - The radiologist reviews both the MIPs and the initial images to identify any vascular abnormalities. A comprehensive analysis is conducted to assess the condition of the blood vessels.
  • Report Generation - Finally, the radiologist compiles a written report detailing the findings from the MRA, which is then communicated to the referring physician for further evaluation and management.

3. Post-Procedure

After the magnetic resonance angiography procedure, patients are typically monitored for a short period to ensure there are no immediate adverse reactions, especially if contrast material was used. Patients may resume normal activities shortly after the procedure, although specific instructions regarding any restrictions or follow-up appointments will be provided by the healthcare provider. The results of the MRA will be discussed in a follow-up consultation, where the physician will review the findings and recommend any necessary further evaluations or treatments based on the results.

Short Descr MR ANGIO PELVIS W/O & W/DYE
Medium Descr MRA PELVIS W/WO CONTRAST MATERIAL
Long Descr Magnetic resonance angiography, pelvis, with or without contrast material(s)
Status Code Active Code
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) 0 - Payment restriction for assistants at surgery applies to this procedure...
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
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.
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.
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).
GC This service has been performed in part by a resident under the direction of a teaching physician
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
GZ Item or service expected to be denied as not reasonable and necessary
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).
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.
CR Catastrophe/disaster related
GA Waiver of liability statement issued as required by payer policy, individual case
GV Attending physician not employed or paid under arrangement by the patient's hospice provider
GW Service not related to the hospice patient's terminal condition
MA Ordering professional is not required to consult a clinical decision support mechanism due to service being rendered to a patient with a suspected or confirmed emergency medical condition
MC Ordering professional is not required to consult a clinical decision support mechanism due to the significant hardship exception of electronic health record or clinical decision support mechanism vendor issues
ME The order for this service adheres to appropriate use criteria in the clinical decision support mechanism consulted by the ordering professional
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
Q6 Service furnished under a fee-for-time compensation arrangement by a substitute physician or by a substitute physical therapist furnishing outpatient physical therapy services in a health professional shortage area, a medically underserved area, or a rural area
QQ Ordering professional consulted a qualified clinical decision support mechanism for this service and the related data was provided to the furnishing professional
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
X4 Episodic/focused services: for reporting services by clinicians who provide focused care on particular types of treatment limited to a defined period and circumstance; the patient has a problem, acute or chronic, that will be treated with surgery, radiation, or some other type of generally time-limited intervention; reporting clinician service examples include but are not limited to, the orthopedic surgeon performing a knee replacement and seeing the patient through the postoperative period
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
XP Separate practitioner, a service that is distinct because it was performed by a different practitioner
XS Separate structure, a service that is distinct because it was performed on a separate organ/structure
XU Unusual non-overlapping service, the use of a service that is distinct because it does not overlap usual components of the main service
Date
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Notes
1994-01-01 Added First appearance in code book in 1994.
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