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Functional Magnetic Resonance Imaging of the Brain for Presurgical Mapping or Seizure Focus Localization
Blue Cross & Blue Shield of Mississippi·MS · Neurosurgery, Neurology, Radiology·Medical Policy
Effective date
Jan 31, 2025
We identified it
Jun 20, 2026
Summary
Blue Cross Blue Shield updated policy L.6.01.423 for functional MRI brain imaging, changing the title to specify presurgical mapping and seizure focus localization, and changing the policy number from A.6.01.47. The policy statements for medical necessity remain unchanged - fMRI is covered as complementary testing before neurosurgery when lesions are near eloquent brain areas.
Action Required
By February 1, 2025: Billing team should update internal policy references from old policy number A.6.01.47 to new policy number L.6.01.423 for functional MRI brain imaging procedures. No changes to billing codes or coverage criteria are required as policy statements remain unchanged.