On July 20, 2017, the Centers for Medicare and Medicaid Services (CMS) responded favorably to a multi-medical society appeal to increase the Medically Unlikely Edit (MUE) value of CPT code 75705 (Angiography, spinal, selective, radiological supervision and interpretation) from 13 to 20.
In their joint appeal, the American College of Radiology (ACR), Society of Interventional Radiology and American Society of Neuroradiology argued that the MUE for CPT code 75705 should be 29.
The MUE value is the maximum units of service that a provider may report under most circumstances for a single beneficiary on a single date of service. Payment claims for procedures involving more units than the MUE value are routinely denied. To gain payment, providers must submit adequate documentation of medical necessity upon appeal to address the unusual circumstances.
Though less uncommon than other angiographic applications, spinal angiography serves an incredibly important role for diagnosing and managing specific spinal issues. For example, in patients with unexplained myelopathy, extensive spinal angiography may be required to search for a spinal dural fistula or arteriovenous malformation.
These procedures often require selective angiography of every spinal artery branch, and these arise from most right and left intercostal and lumbar arteries. A complete spinal angiogram commonly involves 29 arteries including selective angiograms of bilateral T3 through T12 intercostal arteries, bilateral L1 through L4 lumbar arteries and the middle sacral artery.
For more information, please contact the ACR’s Maria Tran at firstname.lastname@example.org.