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Magnetic resonance angiography (MRA) is a specialized imaging technique that focuses on the upper extremities, specifically the upper or lower arm, to assess the condition of arterial and venous vessels. This noninvasive procedure can be performed with or without the administration of contrast material, which may enhance the visibility of blood vessels during imaging. MRA utilizes a powerful magnetic field combined with pulses of radiowave energy to generate detailed images of the blood vessels, allowing for the evaluation of various vascular conditions. These conditions may include atherosclerotic stenosis, which is the narrowing of arteries due to plaque buildup; arterial dissection, where the inner layer of an artery tears; acute thrombosis, the formation of a blood clot; aneurysms or pseudo-aneurysms, which are abnormal bulges in blood vessels; vascular loops, and vascular malformations or tumors. The imaging process involves obtaining multiple images, typically 1-2 mm in thickness, which are then processed using advanced algorithms to create maximum intensity projections (MIPs). These MIPs serve a similar purpose to subtraction angiograms, allowing for clearer visualization of areas of interest. A radiologist reviews the MIPs alongside the initial MRA images, identifying specific areas that require further examination. The final interpretation of the findings is documented in a written report by the radiologist, providing essential information for clinical decision-making.
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Magnetic resonance angiography (MRA) of the upper extremity is indicated for the evaluation of various vascular conditions. The following conditions may warrant the use of this imaging technique:
The procedure for magnetic resonance angiography (MRA) of the upper extremity involves several key steps to ensure accurate imaging and assessment of the vascular structures. The following procedural steps are typically followed:
After the magnetic resonance angiography (MRA) procedure is completed, patients may be monitored briefly, especially if contrast material was administered. Generally, there are no specific post-procedure care requirements, as MRA is a noninvasive procedure with minimal side effects. Patients can typically resume their normal activities immediately following the examination. However, if contrast material was used, patients may be advised to drink plenty of fluids to help flush the contrast from their system. Any unusual symptoms or reactions should be reported to a healthcare provider promptly. The results of the MRA will be communicated 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.
| Short Descr | MR ANGIO UPR EXTR W/O&W/DYE | Medium Descr | MRA UPPER EXTREMITY W/WO CONTRAST MATERIAL | Long Descr | Magnetic resonance angiography, upper extremity, 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 | 2 | 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. | 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). | 53 | Discontinued procedure: under certain circumstances, the physician or other qualified health care professional may elect to terminate a surgical or diagnostic procedure. due to extenuating circumstances or those that threaten the well being of the patient, it may be necessary to indicate that a surgical or diagnostic procedure was started but discontinued. this circumstance may be reported by adding modifier 53 to the code reported by the individual for the discontinued procedure. note: this modifier is not used to report the elective cancellation of a procedure prior to the patient's anesthesia induction and/or surgical preparation in the operating suite. for outpatient hospital/ambulatory surgery center (asc) 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 | GC | This service has been performed in part by a resident under the direction of a teaching physician | GZ | Item or service expected to be denied as not reasonable and necessary | LT | Left side (used to identify procedures performed on the left side of the body) | 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 | RT | Right side (used to identify procedures performed on the right side of the body) | 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 | 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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