ARCHIVED


6.01.02ARCHIVADA IMAGEN POR RESONCIA MAGNÉTICA
SecciónRadiología Fecha Original: 14 de febrero de 1997
SubsecciónRadiología Fecha Revisión10 de mayo de 2016
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Definición


MRI es una modalidad diagnóstica que se obtiene mediante el uso de campos magnéticos (fijos y variables) y de ondas de radio para producir una imagen de frecuencias. De esta forma se visualiza la anatomía y anormalidades relacionadas a la forma, el flujo vascular y al contenido de agua de los tejidos en el cuerpo.
El MRI utiliza radiación no ionizada y no es impedido por los huesos.
Política
La resonancia magnética requiere preautorización para evaluar la necesidad médica del servicio en las cubiertas que así lo establecen. Se recomienda utilizar la tabla de guía para evaluar las pruebas diagnósticas de primera línea relevantes a cada área anatómica.
El material de contraste no requiere preautorización, una vez pre-autorizada la Resonancia Magnética. El participante que realiza el estudio es el perito que decide su uso. Referirse al tema Contraste para Resonancia Magnética.
Códigos
CODIGOS CPT NUMEROS DESCRIPCION
70336 Magnetic resonance (eg, proton) imaging, temporomandibular joint(s)
70540 Magnetic resonance (eg, proton) imaging, orbit, face, and neck; without contrast material(s)
70542 Magnetic resonance (eg, proton) imaging, orbit, face, and neck; with contrast material(s)
70543 Magne Magnetic resonance (eg, proton) imaging, orbit, face, and neck; without contrast material(s), followed by contrast material(s) and further sequences
70551 Magnetic resonance (eg, proton) imaging, brain (including brain stem); without contrast material
70552 Magnetic resonance (eg, proton) imaging, brain (including brain stem); with contrast material(s)
70553 Magnetic resonance (eg, proton) imaging, brain (including brain stem); without contrast material, followed by contrast material(s) and further sequences
71550 Magnetic resonance (eg, proton) imaging, chest (eg, for evaluation of hilar and mediastinal lymphadenopathy); without contrast material(s)
71551 Magnetic resonance (eg, proton) imaging, chest (eg, for evaluation of hilar and mediastinal lymphadenopathy); with contrast material(s)
71552 Magnetic resonance (eg, proton) imaging, chest (eg, for evaluation of hilar and mediastinal lymphadenopathy); without contrast material(s), followed by contrast material(s) and further sequences
72141 Magnetic resonance (eg, proton) imaging, spinal canal and contents, cervical; without contrast material
72142 Magnetic resonance (eg, proton) imaging, spinal canal and contents, cervical;with contrast material(s)
72146 Magnetic resonance (eg, proton) imaging, spinal canal and contents, thoracic; without contrast material
72147 Magnetic resonance (eg, proton) imaging, spinal canal and contents, thoracic; with contrast material(s)
72148 Magnetic resonance (eg, proton) imaging, spinal canal and contents, lumbar; without contrast material
72149 Magnetic resonance (eg, proton) imaging, spinal canal and contents,lumbar; with contrast material(s)
72156 Magnetic resonance (eg, proton) imaging, spinal canal and contents, without contrast material, followed by contrast material(s) and further sequences;cervical
72157 Magnetic resonance (eg, proton) imaging, spinal canal and contents, without contrast material, followed by contrast material(s) and further sequences; thoracic
72158 Magnetic resonance (eg, proton) imaging, spinal canal and contents, without contrast material, followed by contrast material(s) and further sequences; lumbar
72195 Magnetic resonance (eg, proton) imaging, pelvis; without contrast material(s)
72196 Magnetic resonance (eg, proton) imaging, pelvis; with contrast material(s)
72197 Magnetic resonance (eg, proton) imaging, pelvis; without contrast material(s), followed by contrast material(s) and further sequences
73218 Magnetic resonance (eg, proton) imaging, upper extremity, other than joint; without contrast material(s)
73219 Magnetic resonance (eg, proton) imaging, upper extremity, other than joint; with contrast material(s)
73220 Magnetic resonance (eg, proton) imaging, upper extremity, other than joint; without contrast material(s), followed by contrast material(s) and further sequences
73221 Magnetic resonance (eg, proton) imaging, any joint of upper extremity; without contrast material(s)
73222 Magnetic resonance (eg, proton) imaging, any joint of upper extremity; with contrast material(s)
73223 Magnetic resonance (eg, proton) imaging, any joint of upper extremity; without contrast material(s), followed by contrast material(s) and furthersequences
73718 Magnetic resonance (eg, proton) imaging, lower extremity other than joint; without contrast material(s)
73719 Magnetic resonance (eg, proton) imaging, lower extremity other than joint; with contrast material(s)
73720 Magnetic resonance (eg, proton) imaging, lower extremity other than joint; without contrast material(s), followed by contrast material(s) and further sequences
73721 Magnetic resonance (eg, proton) imaging, any joint of lower extremity; without contrast material
73722 Magnetic resonance (eg, proton) imaging, any joint of lower extremity; without contrast material
73722 Magnetic resonance (eg, proton) imaging, any joint of lower extremity; with contrast material(s)
73723 Magnetic resonance (eg, proton) imaging, any joint of lower extremity; without contrast material(s), followed by contrast material(s) and further sequences
74181 Magnetic resonance (eg, proton) imaging, abdomen; without contrast material(s
74182 Magnetic resonance (eg, proton) imaging, abdomen; with contrast material(s)
74183 Magnetic resonance (eg, proton) imaging, abdomen; without contrast material(s), followed by with contrast material(s) and furthersequences
75557 Cardiac magnetic resonance imaging for morphology and fuction without contrast material
75561 Cardiac magnetic resonance imaging for morphology and function without contrast material(s), followed by contrast material(s) and further sequences;
75565 Cardiac magnetic resonance imaging for velocity flow mapping (List separately in addiction to code for primary procedure)

Limitación
Según establecido en póliza.
___________ ____________________________________
Ángela Hernández, MD Enid M. Mateo Reyes, MD
Director Médico Asociado Director Médico Asociado
Rev. 05/10/2016
05/16/2013
10/02/12 (se añadieron CPT autorizados por la Dra. Hernández)
05/13/09 (iCES)
09/11/06

Referencias

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  • Roemer PB, Edelstein WA, Hayes CE, Souza SP, Mueller OM. (Nov 1990). "The NMR phased array.". Magn Reson Med. 16 (2): 192-225

  • Le Bihan D, Breton E, Lallemand D, Grenier P, Cabanis E, Laval-Jeantet M. (November 1986). "MR imaging of intravoxel incoherent motions: Application to diffusion and perfusion in neurologic disorders." Radiology. 161 (2): 401–7

  • Colosimo C, Celi G, Settecasi C, Tartaglione T, Di Rocco C, Marano P. (1995 October). "Magnetic resonance and computerized tomography of posterior cranial fossa tumors in childhood. Differential diagnosis and assessment of lesion extent" (in Italian). Radiol Med (Torino) 90 (4): 386–95

  • Current Procedural Terminology (2016) American Medical Association