Lumbar MRI

Lumbar MRI is covered for suspected myelopathy, spinal cord compression, tumor, infection, congenital dysraphism, cauda equina or progressive/major neurologic deficits, evaluation before surgery, and for non–red-flag low back pain only after ≥4 weeks of conservative management; excluded/investigational items include blood‑flow measurements, spectroscopy, imaging of cortical bone or calcifications, and scans contraindicated with vascular metallic clips or contrast-allergic patients. Coverage requires FDA-approved MRI equipment, a signed physician order, documentation of clinical findings/prior treatment and appropriate ICD‑10 codes, a separate complete written interpretation, and payment is generally limited to one MRI and one professional component unless additional justification is documented.

"Payment for a single lumbar MRI procedure includes two and three sequences (i."