Magnetic Resonance Angiography (MRA) and Magnetic Resonance Venography (MRV) — CPB 0094 | AETNA Coverage Update

Aetna modified CPB 0094 covering MRA and MRV billing, effective September 26, 2025. Here's what billing teams need to do.

Aetna, a CVS Health company, updated its Magnetic Resonance Angiography (MRA) and Magnetic Resonance Venography (MRV) coverage policy under CPB 0094 Aetna system, effective September 26, 2025. This modification affects 24 CPT codes and 12 HCPCS codes—including head, neck, chest, abdomen, pelvis, spinal canal, and extremity MRA codes ranging from 70544 through 73725. If your team bills these imaging codes for Aetna members, review your medical necessity documentation and prior authorization workflows before the effective date passes.

Quick-Reference Table

Aetna MRA and MRV Coverage Criteria and Medical Necessity Requirements 2025

The Aetna MRA and MRV coverage policy under CPB 0094 covers these imaging services when specific medical necessity criteria are met. Aetna does not cover MRA or MRV as routine or screening studies. Coverage requires documented clinical indications that justify the study over alternative imaging modalities.

The policy spans a wide range of anatomic regions. Head MRA (CPT 70544, 70545, 70546), neck MRA (CPT 70547, 70548, 70549), chest MRA (CPT 71555), spinal canal MRA (CPT 72159), pelvis MRA (CPT 72198), lower extremity MRA (CPT 73725), and abdominal MRA (CPT 74185) are all covered when selection criteria are satisfied. The HCPCS equivalents—C8900 through C8902 for abdomen, C8909 through C8911 for chest, and C8912 through C8914 for lower extremity—follow the same rules at the facility level.

The ICD-10 diagnosis code attached to the claim carries significant weight here. Aetna maps coverage to nearly 500 specific diagnosis codes. These span cerebrovascular conditions, vascular malformations, neoplasms, coagulation defects (D68.0–D68.9), sickle cell disorders (D57.00–D57.819), diabetes mellitus (E08.9–E13.9), meningitis (G00.0–G03.9), and intracranial phlebitis (G08). An MRA claim with a non-qualifying diagnosis code will deny regardless of clinical rationale in the notes.

Prior authorization requirements for MRA and MRV under Aetna commercial plans vary by plan type and region. Check authorization requirements before scheduling—especially for outpatient facility and freestanding imaging center settings, where Aetna's radiology benefit management programs most commonly apply. If you use a radiology benefit manager (RBM) like NIA or Carelon for your Aetna book of business, this policy update should trigger a workflow review with your authorization team.

Contrast agent billing adds another layer. Gadofosveset trisodium (HCPCS A9583, brand name Ablavar) is covered when selection criteria are met. Ferumoxytol (Q0138 for non-ESRD use, Q0139 for ESRD on dialysis) appears as a related code. The practical distinction: Q0138 and Q0139 sit in the "other codes related to the CPB" group—meaning they're referenced in the policy context but not in the primary covered-when-criteria-met category. Verify reimbursement and coverage status for ferumoxytol separately before billing it alongside an MRA procedure code.

Coverage Indications at a Glance

Aetna MRA and MRV Billing Guidelines and Action Items 2025

CPT, HCPCS, and ICD-10 Codes for MRA and MRV Under CPB 0094

Covered CPT Codes (When Selection Criteria Are Met)

Covered HCPCS Codes (When Selection Criteria Are Met)

Other CPT Codes Related to CPB 0094 (Not in Primary Covered Group)

Other HCPCS Codes Related to CPB 0094 (Not in Primary Covered Group)

Key ICD-10-CM Diagnosis Codes Covered Under CPB 0094

The full covered diagnosis list runs 498 codes. Below are representative categories your billing team should map to your patient population. Pull the complete list from the source policy at CPB 0094.