HCPCS Coding Requirements

40.1.2 - HCPCS Coding Requirements (Rev. 1472, Issued: 03-06-08, Effective: 05-23-07, Implementation: 04-07-08) Providers must report HCPCS codes when submitting claims for MRA of the chest, abdomen, head, neck or peripheral vessels of lower extremities. The following HCPCS codes should be used to report these services: MRA Code MRA of head 70544, 70544-26, 70544-TC MRA of head 70545, 70545-26, 70545-TC MRA of head 70546, 70546-26, 70546-TC MRA of neck 70547, 70547-26, 70547-TC MRA of neck 70548, 70548-26, 70548-TC MRA of neck 70549, 70549-26, 70549-TC MRA of chest 71555, 71555-26, 71555-TC MRA of pelvis 72198, 72198-26, 72198-TC MRA of abdomen (dates of service on or after July 1, 2003) – see below. 74185, 74185-26, 74185-TC MRA of peripheral vessels of lower extremities 73725, 73725-26, 73725-TC Hospitals subject to OPPS should report the following C codes in place of the above HCPCS codes as follows: • MRA of chest 71555: C8909 – C8911 • MRA of abdomen 74185: C8900 – C8902 • MRA of peripheral vessels of lower extremities 73725: C8912 – C8914 For claims with dates of service on or after July 1, 2003, coverage under this benefit has been expanded for the use of MRA for diagnosing pathology in the renal or aortoiliac arteries. The following HCPCS code should be used to report this expanded coverage of MRA: • MRA, pelvis, with or without contrast material(s) 72198, 72198-26, 72198-TC Hospitals subject to OPPS report the following C codes in place of HCPCS code 72198: • MRA, pelvis, with or without contrast material(s) 72198: C8918 - C8920 NOTE: Information regarding the claim form locator that corresponds to the HCPCS code and a table to crosswalk its CMS-1450 form locator to the 837 transaction is found in Chapter 25.