Magnetic resonance spectroscopy (MRS) (code 76390) is considered investigational for the following reasons: 

• the clinical utility of this diagnostic method has not yet been proven beyond investigational in the clinical setting;
• the scientific evidence is insufficient to permit conclusions regarding the effect of MRS on patient health outcomes; and
• there are no data comparing the results obtained using MRS to other diagnostic modalities (for example, conventional angiography, CT, SPECT, MRI, PET, EEG studies, etc.). 

It is therefore not eligible for reimbursement. A participating, preferred, or network provider can bill the member for services denied as investigational.

Description

Magnetic resonance spectroscopy (MRS) is a noninvasive imaging technique that identifies and quantifies different biochemical molecular structures and concentrations.  The principles of MRS are similar to those of MRI because both imaging modalities use magnetic fields to generate an energy exchange between these external magnetic fields and charged subatomic particles within atoms to produce radiofrequency signals. 

MRS can be performed on commercially available MRI scanners with the aid of specialized computer software programs.  Using complex mathematical algorithms, the computer software translates the radiofrequency signals into an anatomic image by assigning different gray values based on the strength of the emitted signal.  While MRI provides a visual image of an anatomic structure, MRS detects the chemical composition of the scanned tissue.

NOTE:

This policy is designed to address medical guidelines that are appropriate for the majority of individuals with a particular disease, illness, or condition. Each person's unique clinical circumstances may warrant individual consideration, based on review of applicable medical records.

Under the Federal Employee Program, all services that utilize FDA-approved drugs, devices, or biological products are eligible when intended for the treatment of a serious or life-threatening condition and when medically necessary and appropriate for the patient’s condition. Magnetic resonance spectroscopy (MRS) is considered eligible when determined medically necessary based on the patient’s condition.

PRN References

08/2003, Magnetic Resonance Spectroscopy (MRS) considered investigational

National Blue Cross Blue Shield Association TEC Bulletin, Vol. 18, No. 1, June 2003

National Blue Cross Blue Shield Association Medical Policy 6.01.24

Magnetic Resonance Spectroscopy in Medicine: Clinical Impact, Progress in Nuclear Magnetic Resonance Spectroscopy, January 2002

Proton Nuclear Magnetic Resonance Spectroscopy of Body Fluids in the Field of Inborn Errors of Metabolism, Annals of Clinical Biochemistry, January 2003

Hydrogen Magnetic Resonance Spectroscopy in Alzheimer’s Disease, The Lancet Neurology, Vol. 1, No. 2, June 2002

Cardiac Magnetic Resonance Spectroscopy, Current Cardiology Reports, Vol. 5, January 2003

Centers for Medicare and Medicaid Services National Coverage Analysis on Magnetic Resonance Spectroscopy for Brain Tumors (#CAG-00141N)

The American College of Radiology’s Standard for the Performance and Interpretation of Magnetic Resonance Spectroscopy of the Brain, effective January 2003