D78.31 — Postprocedural hematoma of the spleen following a procedure on the spleen
ICD-10-CM
Prior Authorization
No Prior Auth Required
Code is covered without prior authorization (high confidence)
Documentation Required
- This billing and coding guideline complements Local Coverage Determination (LCD) L34424 for Magnetic Resonance Angiography; refer to LCD L34424 for clinical indications, medical necessity criteria, and specific coding rules.
- Medical records must document that MRA is reasonable and necessary for the patient's diagnosis or treatment and, where claimed, that it replaces a more invasive test and reduces risk; coverage follows CMS NCD Pub. 100-03, Ch.1, Pt.4, §220.2.
Key Coverage Criteria
- MRA (with or without contrast) is covered when it can replace a more invasive diagnostic test (e.g., contrast angiography) and thereby reduce risk to the beneficiary.
- MRA is covered for diagnosis and assessment of diseases and abnormalities of the arterial, venous, and lymphatic systems at any anatomic location when reasonable and necessary for the specific patient's diagnosis or treatment.
- Coverage and definition of MRA are subject to the CMS Internet-Only Manual, Pub. 100-03, Medicare NCD Manual, Chapter 1, Part 4, §220.2; MRA is considered appropriate consistent with that NCD.
3 Active Policies
A59845 — Billing and Coding: Magnetic Resonance Angiography
A56775 — Billing and Coding: Magnetic Resonance Angiography
L34424 — Magnetic Resonance Angiography
Related Codes
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