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CMS-1403-FC
national noncoverage determination (NCD) for MRI when blood
flow velocity measurement is a component, or comprises all,
of the service. As a result, we assigned a status
indicator of “N” (Noncovered) to four of the new CPT codes
(75558, 75560, 75562, and 75564).
Comment: Some commenters expressed disappointment
that these four new MRI codes were designated as noncovered
and stated that they did not believe the existing NCD for
MRI is applicable to flow and velocity measurements.
Response: We have reviewed the information submitted
by the commenters and the national noncoverage
determination. We have determined that the existing NCD
for MRI is applicable to these codes because blood
flow/velocity quantification is considered to be a
component of these services, which according to the NCD is
not considered reasonable and necessary, and therefore, is
noncovered. Any changes in coverage would have to occur
through the NCD process.
3. Non-Face-to-Face Physician and Qualified Healthcare
Professional Services
For CY 2008, the CPT Editorial Panel created eight new
codes (CPT codes 98966, 98967, 98968, 98969, 99441, 99442,
99443, and 99444) to describe Evaluation and Management
(E/M) services furnished by a physician or qualified
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