C8911 Chest MRA Reimbursement & Policy

HCPCS Level II code C8911 denotes a two-phase magnetic resonance angiography (MRA) of the chest performed without contrast followed by repeat imaging with contrast, excluding the myocardium. This study is an important diagnostic tool for evaluating thoracic vascular structures such as the aorta and its branches, providing both non-contrast and contrast-enhanced information in a single encounter. Nationally, the use of combined non-contrast and contrast MRA protocols supports diagnostic accuracy for vascular disease while informing care decisions for patients with suspected aortic pathology or other chest vascular conditions.

Key payers covered in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise overview of clinical context, common billing considerations, and the payment landscape across major national payers. The publication summarizes typical sites of service and service components, highlights common modifiers used in practice (list provided separately), and presents benchmarking and policy updates relevant to imaging services. The content is intended to help billing managers, reimbursement analysts, and clinical program leads understand how HCPCS Level II code C8911 fits into diagnostic imaging workflows and payer coverage frameworks at a national level.

Billing Code Overview

HCPCS Level II code C8911 describes magnetic resonance angiography without contrast followed by with contrast of the chest (excluding myocardium). This service typically involves performing a non-contrast MRA sequence first and then administering contrast to complete the angiographic evaluation of thoracic vasculature, excluding imaging of the heart muscle.

Service type: Diagnostic imaging — magnetic resonance angiography (MRA) with and without contrast
Typical site of service: Hospital outpatient department or independent diagnostic imaging center

Clinical Context

A 62-year-old patient with known peripheral vascular disease and progressive exertional dyspnea is referred for vascular imaging to evaluate suspected thoracic aortic disease and central pulmonary arterial pathology. The ordering physician requests a magnetic resonance angiography (MRA) of the chest performed first without contrast sequences (time-of-flight and non-contrast flow-sensitive sequences) followed by contrast-enhanced sequences to better delineate vessel lumen, aneurysm extent, dissection flap, or pulmonary arterial thrombus. Typical workflow: patient registration and screening for MRI safety (implants, pacemakers, renal function for gadolinium), placement of IV access, acquisition of non-contrast MRA sequences, administration of gadolinium-based contrast agent with dynamic contrast-enhanced chest MRA sequences, post-processing with MIP and 3D reconstructions, radiologist interpretation and dictated report, and communication of critical findings to the referring clinician. Typical site of service is an outpatient imaging center, hospital outpatient radiology department, or ambulatory surgical center with MRI capability. Common clinical indications include evaluation of thoracic aortic aneurysm or dissection, suspected pulmonary embolism when CT is contraindicated, central venous stenosis, or pre-procedural vascular mapping for thoracic endovascular repair.

Coding Specifications

Modifier	Description	When to Use
`26`	Professional component	When billing physician reports interpretation only and technical component billed separately

Taxonomy Code	Specialty	Notes
2085R0200X	Radiology (Diagnostic Radiology)	Most frequent interpreting specialty for chest MRA
2086P0200X	Diagnostic Radiology — Neuroradiology/Interventional Radiology overlap	Radiologists with vascular imaging expertise who perform complex MRA protocols
207RC0000X	Emergency Medicine	Ordering clinicians in acute settings evaluating suspected pulmonary embolism or aortic emergencies
2084P0800X	Cardiovascular Disease	Cardiologists ordering preoperative vascular mapping and assessment of aortic pathology
174400000X	Vascular Surgery	Surgeons requesting imaging for operative planning

Related Diagnoses

ICD-10 Code	Description	Clinical Relevance
`I71.2`	Thoracic aortic aneurysm, ruptured	MRA chest without and with contrast evaluates aneurysm size, extent, and rupture-related findings when CT is contraindicated
`I71.1`	Thoracic aortic aneurysm, without rupture	Used to characterize aneurysm morphology and plan surveillance or repair
`I71.01`	Dissection of thoracic aorta, initial	Critical indication for chest MRA to identify intimal flap and true/false lumen when CT angiography is inadvisable
`I26.9`	Pulmonary embolism without acute cor pulmonale	MRA chest can be used when iodinated contrast or radiation exposure is a concern and for central pulmonary arterial evaluation
`I82.401`	Acute embolism and thrombosis of unspecified deep veins of unspecified lower extremity	Indirect relevance when assessing for central thromboembolic disease or source evaluation in the chest
`J98.4`	Other disorders of lung, not elsewhere classified	Symptom-driven indication when vascular causes are suspected and pulmonary pathology needs vascular correlation
`R07.9`	Chest pain, unspecified	Common presenting symptom prompting vascular imaging to exclude aortic or pulmonary vascular causes

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`71555`	Magnetic resonance angiography, chest, without contrast material followed by contrast material and further sequences (separate procedure)	Directly corresponds to a CPT-level MRA chest study performed without then with contrast; often billed when facility uses CPT coding instead of HCPCS Level II
`74185`	Magnetic resonance angiography, abdomen, without and with contrast material, including time-resolved imaging, if performed; with 3D MIP	Performed when thoracic MRA is extended to include abdominal aorta for aneurysm evaluation or endovascular planning
`75561`	MRI, heart, for morphology and function without contrast, followed by contrast with flow or perfusion when indicated	Performed when cardiac structures require evaluation in addition to chest vasculature; note `C8911` excludes myocardium but may be temporally related
`93975`	Duplex scan of extracranial arteries; limited or follow-up study	Non-invasive ultrasound often performed before or after MRA for peripheral vascular assessment
`71275`	CT angiography, chest, without contrast followed by contrast and further sections; with contrast material(s)	Alternative imaging modality when MRA is contraindicated or for comparative evaluation

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Summary & Overview

HCPCS C8911: Chest Magnetic Resonance Angiography Without and With Contrast