Mountain State Medical Policy Bulletin |
Section: | Radiology |
Number: | X-50 |
Topic: | Magnetic Resonance Spectroscopy (MRS) |
Effective Date: | August 1, 2005 |
Issued Date: | July 2, 2007 |
Date Last Reviewed: | 07/2007 |
Indications and Limitations of Coverage
Magnetic resonance spectroscopy (MRS) (code 76390) is considered investigational for the following reasons:
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. |
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76390 |
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. |
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 |
[Version 001 of X-50] |