Magnetic Resonance Angiography (MRA) and Magnetic Resonance Venography (MRV) (CPB 0094, reviewed 2026-03-26)

By 2026-03-26: Billing team must implement Aetna authorization requirements for all MRA/MRV procedures using CPT codes 70544, 70545, 70546, and 70547 (and additional codes referenced in full policy table). Update billing system to enforce prior authorization requirements based on specific medical necessity criteria listed in the policy: (1) Head/neck MRA requires documented indication such as AVM follow-up, post-coiling evaluation, vertebrobasilar syndrome symptoms, carotid pathology, etc.; (2) Chest MRA requires thoracic aorta conditions, CHD evaluation, or pulmonary embolism with contrast contraindication; (3) Abdomen/pelvis MRA requires renal artery stenosis with refractory hypertension, sickle cell assessment, peripheral vascular disease, or other specific indications; (4) Lower extremity MRA requires initial diagnostic/surgical planning documentation. Update provider encounter forms and clinical decision support to document which specific medical necessity criterion applies. Flag claims lacking documented criteria alignment as requiring denial. Communicate to billing staff and providers that claims for experimental/investigational indications (including cardiac velocity flow mapping, cerebral AVM diagnosis, renal donor evaluation, dural sinus thrombosis evaluation, coronary MRA, and ferumoxytol-enhanced studies) will be systematically denied. Failure to obtain proper authorization and medical necessity documentation will result in claim denials.