Summary & Overview
HCPCS C8913: Magnetic Resonance Angiography Without Contrast, Lower Extremity
HCPCS Level II code C8913 designates magnetic resonance angiography (MRA) of the lower extremity performed without intravenous contrast. This non-contrast vascular imaging technique is used to evaluate peripheral arterial disease, arterial stenosis, and other vascular abnormalities in the legs, offering a radiation-free alternative to CT angiography and contrast-based MR techniques. Nationally, the code is relevant for imaging utilization, modality selection, and payer coverage policies as clinicians and payers balance diagnostic yield with safety considerations for patients with contrast contraindications.
Key payers discussed include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find an overview of clinical context and the primary service setting, plus payer coverage considerations and common billing practices. The publication summarizes available benchmarks for utilization and reimbursement patterns, outlines relevant policy updates that affect coverage and prior authorization, and highlights coding and billing nuances specific to non-contrast lower extremity MRA. The content is intended to inform coding professionals, radiology administrators, and policy analysts about the operational and policy implications of using HCPCS Level II code C8913 in clinical practice.
Billing Code Overview
HCPCS Level II code C8913 describes magnetic resonance angiography without contrast of the lower extremity. This service is an imaging procedure that uses magnetic resonance technology to visualize blood vessels in the legs without the administration of intravenous contrast material. The service type is diagnostic vascular imaging. The typical site of service is an outpatient radiology or hospital imaging center where MR angiography studies are performed.
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Clinical & Coding Specifications
Clinical Context
A 68-year-old patient presents with progressive claudication in the left calf, decreased ankle-brachial index, and nondiagnostic duplex ultrasound of the femoropopliteal segment. The vascular surgeon schedules a diagnostic vascular imaging study to evaluate arterial stenosis and occlusion in the lower extremities. The procedure performed is C8913 — magnetic resonance angiography without contrast, lower extremity. The clinical workflow includes preauthorization if required, review of prior imaging and renal function (contrast not used), patient screening for MRI safety (implants, pacemaker, metal), IV access only if needed for monitoring, positioning of the patient supine in the MR scanner, acquisition of time-of-flight or non-contrast MRA sequences covering the pelvis through the distal lower extremities, image post-processing by the radiologist, and a formal radiology report describing arterial narrowing, occlusion, flow characteristics, and collateralization. Results are communicated to the referring vascular specialist for treatment planning, which may include medical management, endovascular intervention, or surgical bypass based on the imaging findings.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
26 | Professional component | When billing provider reports interpretation only separate from technical facility charge |