Magnetic Resonance Imaging (MRI) of the Extremities

Covered for knee tumor evaluation, suspected osteomyelitis, true locking suggestive of meniscal tear/loose body, persistent non‑traumatic knee pain/swelling/instability not responding to ≥3 weeks of conservative therapy, and persistent post‑injury symptoms unresponsive to conservative care when multi‑view x‑rays have excluded fracture or loose body and the clinical picture remains uncertain. Excluded/not covered for implant fitting for total knee arthroplasty and considered experimental/investigational when MRI would not change planned arthroscopy/ligament reconstruction, when the clinical picture is already diagnostic with high certainty (e.g., torn meniscus, loose body, osteochondritis dissecans), or to diagnose/evaluate rheumatoid arthritis or degenerative joint disease.

"ICD-10 code covered if selection criteria are met for MRI-lymphangiography: I89."

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