HCPCS C8919: Magnetic Resonance Angiography, Pelvis, No Contrast - OpenPayer

Summary & Overview

HCPCS C8919: Magnetic Resonance Angiography, Pelvis, No Contrast

HCPCS Level II code C8919 denotes magnetic resonance angiography (MRA) of the pelvis performed without intravenous contrast. This non-contrast vascular imaging study is used to evaluate pelvic arterial and venous anatomy and pathology when contrast administration is contraindicated or unnecessary. Nationally, non-contrast MRA is relevant for vascular assessment, postoperative surveillance, and evaluation of suspected vascular lesions while avoiding contrast-related risks.

Key payers in the analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare and Medicare. Readers will find a concise overview of clinical context for non-contrast pelvic MRA, typical sites of service, and the role of C8919 within imaging service lines. The publication outlines benchmarking and coverage considerations used by major payers, common billing practices for technical and professional components, and policy updates that affect when non-contrast MRA is billed versus contrast-enhanced studies.

The material explains how C8919 is applied in clinical workflows, typical documentation elements that support medical necessity, and how this code integrates with related imaging and vascular service lines. Data not available in the input is noted where applicable.

AetnaBlue Cross Blue ShieldCigna HealthUnitedHealthcareMedicareC8919HCPCS Level IImagnetic resonance angiographypelvis imagingnon-contrast MRAdiagnostic imagingradiology billingimaging service lineoutpatient imaging

Billing Code Overview

HCPCS Level II code C8919 represents magnetic resonance angiography without contrast of the pelvis. The service is an imaging study that uses magnetic resonance technology to evaluate pelvic blood vessels without the use of intravenous contrast agents. The service type is diagnostic imaging (magnetic resonance angiography, non-contrast). The typical site of service is hospital outpatient imaging center or freestanding outpatient radiology clinic, where MR scanners and vascular imaging protocols for pelvic studies are available.

Clinical & Coding Specifications

Clinical Context

A 62-year-old patient with progressive claudication and known peripheral arterial disease is referred for vascular imaging to evaluate pelvic and proximal lower extremity arterial anatomy. The patient has chronic kidney disease stage 3, limiting use of iodinated or gadolinium-based contrast agents. The ordering vascular surgeon requests a non-contrast vascular study to assess arterial stenosis, occlusion, or aneurysm in the pelvis prior to planning revascularization.

The clinical workflow: the referring clinician orders C8919 (magnetic resonance angiography without contrast, pelvis). The patient arrives at the outpatient imaging center or hospital radiology department (typical sites of service include outpatient hospital radiology suite or freestanding imaging center). Intake includes verification of indications, screening for MRI safety (implants, pacemaker, ferromagnetic material), and renal status to confirm contrast avoidance. A certified MRI technologist performs the non-contrast MRA protocol of the pelvis using time-of-flight or phase-contrast and arterial spin labeling techniques. The study is interpreted by a board-certified diagnostic radiologist or vascular radiologist, with a finalized report documenting arterial anatomy, presence/degree of stenosis or occlusion, and recommendations for correlation with clinical findings. Technical component billing may be separated from the professional interpretation when applicable using appropriate modifiers and TC and 26 components as needed.

Coding Specifications

Modifier	Description	When to Use

HCPCS C1748: Single-Use Upper GI Endoscope, Imaging/Illumination

HCPCS-C7563-TRANSLUMINAL-BALLOON-ANGIOPLASTY-NON-EXCLUDED-ARTERIES

HCPCS C7563: Transluminal Balloon Angioplasty, Non-Excluded Arteries

HCPCS-C8900-MAGNETIC-RESONANCE-ANGIOGRAPHY-ABDOMEN-CONTRAST

HCPCS C8900: Magnetic Resonance Angiography with Contrast, Abdomen

HCPCS-C7537-PACEMAKER-LEFT-VENTRICULAR-TRANSVENOUS-LEAD-INSERTION

HCPCS C7537: Pacemaker with Atrial and Cardiac Venous LV Lead Insertion

HCPCS-C8928-TRANSTHORACIC-ECHOCARDIOGRAPHY-CONTRAST-STRESS-TESTING

HCPCS C8928: Transthoracic Echocardiography with Contrast During Stress Testing

HCPCS-C9068-COPPER-CU-64-DOTATE-DIAGNOSTIC-1-MILLICURIE

HCPCS Level II C9068: Copper Cu-64 dotatate, Diagnostic, 1 millicurie

HCPCS-C1893-INTRACARDIAC-ELECTROPHYSIOLOGY-INTRODUCER-SHEATH

HCPCS C1893: Intracardiac Electrophysiology Guiding Introducer/Sheath

HCPCS-C9480-TRABECTEDIN-INJECTION-0-1-MG

HCPCS C9480: Injection, trabectedin, 0.1 mg

HCPCS-C9362-POROUS-COLLAGEN-MATRIX-BONE-VOID-FILLER-0-5CC

HCPCS C9362: Porous Collagen Matrix Bone Void Filler, per 0.5 cc

HCPCS-C1834-IMPLANTABLE-INTRAMUSCULAR-PRESSURE-SENSOR-SYSTEM

HCPCS C1834: Implantable Intramuscular Pressure Sensor System

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`26`	Professional component	Use when billing only the radiologist interpretation separate from technical component.
`TC`	Technical component	Use when billing only the technical portion (scanner, technologist) separate from professional read.
`AS`	Ambulatory surgical center facility fee	Use when service provided in an ASC and payer requires the `AS` modifier.
`QX`	Qualified nonphysician health professional modifier (modifier QX used with `QK`/`QY` group)	Use when a qualified nonphysician practitioner performs or assists with the imaging service under the payer's rules.
`QK`	Medical direction of two, three, or four technicians/qualified health professionals	Use when a physician medically directs multiple staff during the imaging procedure per payer policy.
`QY`	Medical direction by a physician of one technician/qualified health professional	Use when a physician medically directs a single technician performing the imaging service.
`52`	Reduced services	Use when the procedure is partially reduced or not completed as originally described (e.g., limited sequences due to patient intolerance).
`53`	Discontinued procedure	Use when the procedure is started but aborted for patient safety reasons (e.g., claustrophobia, unstable vitals).
`51`	Multiple procedures	Use when billed on the same day with other distinct procedures; follows payer rules for multiple-procedure reductions.
`62`	Two surgeons	Use when two surgeons of different specialties perform distinct portions of care that relate to imaging-guided interventions (rare for imaging-only service).
`22`	Increased procedural services	Use when work required is substantially greater than usual (e.g., extensive problem-solving to obtain diagnostic images in a difficult patient).
`23`	Unusual procedural services	Use when an anesthesia-type service is provided for acutely painful procedures; occasionally applied if anesthesia is required for imaging and payer requires modifier.
`56`	Preoperative management only	Use when only preoperative management is billed separate from the imaging service per payer rules.
`52`	Reduced services	Use when sequences or portions of the MRA are omitted due to clinical reasons.

Taxonomy Code	Specialty	Notes
`2085R0200X`	Diagnostic Radiology	Primary specialty interpreting and performing MRI/MRA studies.
`207K00000X`	Vascular Surgery	Referring and procedural specialists who may use MRA for planning revascularization.
`2080P0202X`	Radiology - Vascular & Interventional	Interprets complex vascular imaging and performs image-guided interventions.
`3336C0005X`	Hospitalist Medicine	Manages inpatient logistics when imaging obtained during hospitalization.
`363L00000X`	Nurse Practitioner	May order and coordinate imaging in outpatient clinics; applicable when nonphysician ordering providers involved.

Related Diagnoses

ICD-10 Code	Description	Clinical Relevance
`I70.21`	Atherosclerosis of native arteries of extremities, bilateral legs	Evaluates arterial occlusive disease affecting pelvic inflow and iliac arteries contributing to claudication.
`I70.22`	Atherosclerosis of native arteries of extremities, left leg	Localizes evaluation for unilateral symptoms when pelvic arterial anatomy is implicated.
`I70.23`	Atherosclerosis of native arteries of extremities, right leg	Localizes evaluation for unilateral symptoms when pelvic arterial anatomy is implicated.
`I74.3`	Embolism and thrombosis of iliac artery	Used when acute or subacute embolic occlusion of pelvic arteries is suspected; non-contrast MRA can show flow voids and occlusion.
`I72.3`	Aneurysm of artery of lower extremity	Identifies aneurysmal disease in iliac or femoral segments; MRA assesses size and extent without contrast.
`R42`	Dizziness and giddiness	Used when pelvic vascular insufficiency causes presyncopal symptoms related to orthostatic intolerance in vascular workup (less common).
`M79.60`	Pain in limb, unspecified	Symptom code that may accompany peripheral arterial disease prompting pelvic vascular imaging.

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`72198`	Magnetic resonance angiography, pelvis, without contrast material(s)	Closely related; CPT code for non-contrast pelvic MRA often billed when CPT reporting is applicable instead of HCPCS Level II.
`74185`	Magnetic resonance angiography, abdominal, without contrast material(s), followed by contrast and further sequences when performed	May be performed when abdominal arterial evaluation is needed in addition to pelvic imaging; provides contiguous evaluation of aortoiliac segments.
`72195`	Magnetic resonance angiography, pelvis, with contrast material(s)	Alternative when contrast is used; contrasts the non-contrast study to document when gadolinium-enabled imaging is performed.
`76536`	Duplex scan of lower extremity arteries or arterial bypass grafts; complete bilateral study	May be performed as an adjunct or follow-up non-invasive test for peripheral arterial disease and to corroborate MRA findings.
`93975`	Duplex scan of extremity arteries, non-invasive physiologic study	Often used alongside MRA for functional hemodynamic assessment or when MRA is contraindicated.
`70551`	MRI brain without contrast (example of non-contrast MRI body region code)	Included to show other non-contrast MRI procedural coding principles; not typically performed with pelvic MRA but demonstrates non-contrast MRI reporting.

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