I89.8 — Other specified noninfective disorders of lymphatic vessels and lymph nodes
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.
- Reason for the study, clinical history and examination findings are required
- Numerical values are required - latency, amplitude and nerve conduction
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.
- Nerve conduction velocity (NCV) testing AND needle electromyography testing (NEMG) are medically necessary when conducted and interpreted at the same time for any of the following indications:
- Myopathy, including but not limited to: inflammatory myopathy and myositis (e.g., polymyositis, dermatomyositis, inclusion body myositis)
- Congenital and hereditary dystrophic and nondystrophic myopathies, including myotonic muscular dystrophy
5 Active Policies
CIGNA-0538 — Flow Cytometry - (0538)
CIGNA-CPG129 — Electrodiagnostic Testing (EMG/NCV) - (CPG129)
A59845 — Billing and Coding: Magnetic Resonance Angiography
A56775 — Billing and Coding: Magnetic Resonance Angiography
L34424 — Magnetic Resonance Angiography
Related Codes
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