The challenges of working around the strong magnetic field inherent with magnetic resonance imaging (MRI) procedures have been dealt with operationally since introduction of the modality, although a rash of accidents increased scrutiny of safety procedures in recent years. The American College of Radiology (ACR) published “The ACR Manual on MR Safety” in 2020 and made numerous updates in 2024. That publication describes elements of safety training based on assigned levels of responsibility, including more extensive requirements for those employees in supervisory positions.
In the end, there are safety guidelines for accreditation and numerous publications offering more specific information but safety programs have been left to individual organizations. Furthermore, there has not been financial recognition by the Centers for Medicare and Medicaid Services for the time and effort involved ensuring patient safety. That may be about to change with the CMS proposal of six new Current Procedural Terminology (CPT) codes related to MR safety.
Proposed MR Safety Codes
CPT Code 7XX00
MR safety implant and/or foreign body assessment by trained clinical staff, including identification and verification of implant components from appropriate sources, analyzing current MR conditional status of individual components and systems, and consulting published professional guidance with written report; initial 15 minutes.
CPT Code 7XX01
MR safety implant and/or foreign body assessment by trained clinical staff, including identification and verification of implant components from appropriate sources, analyzing current MR conditional status of individual components and systems, and consulting published professional guidance with written report; each additional 30 minutes. (List separately in addition to code for primary procedure).
CPT Code 7XX02
MR safety determination by a physician or other qualified health care professional responsible for the safety of the MR procedure, including review of implant MR conditions for indicated MR exam, analysis of risk versus clinical benefit of performing MR exam, and determination of MR equipment, accessory equipment, and expertise required to perform examination with written report.
CPT Code 7XX03
MR safety medical physics examination customization, planning and performance monitoring by medical physicist or MR safety expert, with review and analysis by physician or qualified health care professional to prioritize and select views and imaging sequences, to tailor MR acquisition specific to restrictive requirements or artifacts associated with MR conditional implants or to mitigate risk of nonconditional implants or foreign bodies with written report.
CPT Code 7XX04
MR safety implant electronics preparation under supervision of physician or other qualified health care professional, including MR-specific programming of pulse generator and/or transmitter to verify device integrity, protection of device internal circuitry from MR electromagnetic fields, and protection of patient from risks of unintended stimulation or heating while in the MR room with written report.
CPT Code 7XX05
MR safety implant positioning and/or immobilization under supervision of physician or qualified health care professional, including application of physical protections to secure implanted medical device from MR-induced translational or vibrational forces, magnetically induced functional changes, and/or prevention of radiofrequency burns from inadvertent tissue contact while in the MR room with written report.
Comments
Renée Engle, MSN Senior Vice President, Client Services stated, “The new codes represent a positive step in recognizing the time and expertise involved in maintaining patient safety. While we anticipate approval of the proposed codes, there may be changes following the comment period so we will continue to monitor status and will communicate to all MSN practices impacted. Our coders and documentation experts are on top of these developments and we will carefully monitor implementation.”
She continued, “Oversight of MR procedures has had to adapt to the increased safety implications of devices such as pacemakers, neurostimulators, orthopedic hardware and continuous glucose monitors. This has definitely added to the complexity of those involved performing and supervising the studies so we are pleased to see this development.”
Resources
Proposed Rule for CY 2025 Payment Policies under the Physician Fee Schedule
https://public-inspection.federalregister.gov/2024-14828.pdf (MRI Safety page 152)ACR article CPT Anticipated Code Changes
https://www.acr.org/-/media/ACR/Files/Advocacy/AIA/MarApril-2025-Anticipated-CPT-Code-Changes.pdfArticle “A very, very good thing—CMS proposed reimbursements for providers’ efforts to ensure MSI safety”
https://healthimaging.com/topics/medical-imaging/magnetic-resonance-imaging-mri/very-very-good-thing-cms-proposes-reimbursements-providers-efforts-ensure-mri-safety?utm_source=newsletter&utm_medium=hi_newsACR Manual on MR Safety
https://www.acr.org/-/media/ACR/Files/Radiology-Safety/MR-Safety/Manual-on-MR-Safety.pdf
