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Blue Cross & Blue Shield of MississippiAll Plans · Coverage · Medical Policy · Radiology, NeurologyHigh impact

Magnetic Resonance Imaging (MRI) of the Brain and Head

Effective date
Oct 1, 2026
Identified
Jun 20, 2026

Summary

MRI of the brain or head is medically necessary for indications including aneurysm or arteriovenous malformation, new onset headache or acute neurologic, motor or mental status changes, known or suspected tumor or metastasis, congenital abnormality, shunt malfunction, acute or fluctuating neurologic deficits, multiple sclerosis, seizures with new onset or increasing frequency, stroke, and head trauma with specified findings. A 07/01/2026 policy update added evaluation of patients being treated with amyloid beta targeting plaque-therapy to the covered indications. MRI of the brain and head is not medically necessary for all other indications, including screening of asymptomatic patients. A 10/01/2026 code reference update added ICD-10 code QA1.792 and removed code G35.

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What to do

Action · 9 steps
01Already effective 2026-10-01: Add ICD-10 code QA1.792 (Li Fraumeni syndrome) to the brain and head MRI code reference as a covered diagnosis code, and note that G35 was removed from the code reference.
02CPT 70551, 70552 and 70553 are medically necessary only when the procedure is performed according to the Policy section.
03Evaluation of patients being treated with amyloid beta targeting plaque-therapy is a covered indication, added 07/01/2026.
04The covered codes table includes the Alzheimer's disease code range G30.0 through G30.9, added 07/01/2026.
05Billing team: for repeat brain MRI of the same area within 6 months, documentation should include the radiology reason for study, comparison study date and time, comparison study observation, radiology impression and radiology study recommendation, because imaging beyond one within a 6-month period is subject to medical necessity review.
06Confirm that network providers billing the technical component are accredited in MRI by IAC, an ACR MRI module or RadSite.
07Under State Health Plan membership, this policy applies to MRI of the head and brain in emergency room and non-emergency room settings.
08BCBSMS makes no payment for services not documented to be Medically Necessary.
09Check current applicability of this version at the source link.

Codes mentioned

705517055270553G30.0G30.9

Original notice

Magnetic Resonance Imaging (MRI) of the Brain and Head
bcbsms.com · Always check the source before changing claims.
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Related policy hubs

Blue Cross & Blue Shield of Mississippi policiesRadiologyNeurologyCode 70551Code 70552Code 70553Code G30.0Code G30.9

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