Magnetic Resonance Neurography

Aetna deems magnetic resonance neurography experimental/investigational and does not cover it for any indications (no covered/medically necessary uses are listed), including peripheral nerve disorders and the cited ICD‑10 ranges such as G50–G59 and multiple S‑codes for nerve/spinal injuries. Key requirement: none — the policy states evidence is limited to preliminary small studies so MR neurography is not established for clinical use and there are no specific procedure codes or approved indications.

"ICD-10 injury ranges not covered for indications listed in the CPB (not all-inclusive): S04."

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