DESCRIPTION
Magnetic resonance imaging (MRI) uses strong magnetic fields and radiofrequency energy to interpret as computer-generated images the hydrogen nuclei patterns in the body fluids and tissues. An open magnetic resonance imaging (MRI) system has been developed to allow imaging in various positions other than recumbent and to allow unrestricted movement. The imaging can be conducted with partial or full weight bearing and dynamic-kinetic imaging or images taken during movement can also be obtained.
POLICY
Positional (non-recumbent) magnetic resonance imaging (MRI) is considered investigational.
IMPORTANT REMINDER
We develop Medical Policies to provide guidance to Members and Providers. This Medical Policy relates only to the services or supplies described in it. The existence of a Medical Policy is not an authorization, certification, explanation of benefits or a contract for the service (or supply) that is referenced in the Medical Policy. For a determination of the benefits that a Member is entitled to receive under his or her health plan, the Member's health plan must be reviewed. If there is a conflict between the Medical Policy and a health plan, the express terms of the health plan will govern.
ADDITIONAL INFORMATION
The literature does not identify any studies that determine the incremental value of imaging in more than one position. The evidence is currently insufficient to evaluate whether the use of the positional MRI improves health or treatment outcomes. The studies available do not show the benefit of using positional MRI for evaluating individuals with cervical, thoracic or lumbosacral back pain. Guidelines for interpreting positional MRI results have not been established due to the lack of data.
SOURCES
BlueCross BlueShield Association. Medical Policy Reference Manual. (4:2010). Positional magnetic resonance imaging (6.01.48). Retrieved October 8, 2010 from BlueWeb. (9 articles and/or guidelines reviewed)
Complete Guide to Medicare Coverage Issues [Computer software]. (2010, April). Magnetic resonance imaging (NCD 220.2, p. 2-165, 2-166). Ingenix.
Ferreiro Perez, A., Garcia Isidro, M., Ayerbe, E., Castedo, J., & Jinkins, J. (2007). Evaluation of intervertebral disc herniation and hypermobile intersegmental instability in symptomatic adult patients undergoing recumbent and upright MRI of the cervical or lumbosacral spines. European Journal of Radiology, 62 (3), 444-448. (Level 4 Evidence - Independent study)
Madsen, R., Jensen, T., Pope, M., Sorensen, J., & Bendix, T. (2008). The effect of body position and axial load on spinal canal morphology: An MRI study of central spinal stenosis. Spine, 33 (1), 61-67. (Level 4 Evidence - Independent study)
Suzuki, F., Fukami. T., Tsuji, A., Takagi, K., & Matsuda, M. (2008). Discrepancies of MRI findings between recumbent and upright positions in atlantoaxial lesion. Report of two cases. European Spine Journal, 17 (Suppl 2), S304-S307.
U.S. Food and Drug Administration. (2006, July). Center for Devices and Radiological Health. 510(k) Premarket Notification Database. K061930. Retrieved October 8, 2010 from http://www.accessdata.fda.gov/cdrh_docs/pdf6/K061930.pdf.
Washington State Health Care Authority. (2007). Health technology assessment. Upright MRI. Effectiveness of upright MRI for evaluation of patients with suspected spinal or extra-spinal joint dysfunction. Retrieved October 11, 2010 from http://www.hta.hca.wa.gov/documents/uMRI_final_report.pdf.
ORIGINAL EFFECTIVE DATE: 6/13/2009
MOST RECENT REVIEW DATE: 11/11/2010
ID_BT
Policies included in the Medical Policy Manual are not intended to certify coverage availability. They are medical determinations about a particular technology, service, drug, etc. While a policy or technology may be medically necessary, it could be excluded in a member's benefit plan. Please check with the appropriate claims department to determine if the service in question is a covered service under a particular benefit plan. Use of the Medical Policy Manual is not intended to replace independent medical judgment for treatment of individuals. The content on this Web site is not intended to be a substitute for professional medical advice in any way. Always seek the advice of your physician or other qualified health care provider if you have questions regarding a medical condition or treatment.
This document has been classified as public information.