Anthem Blue Cross Connecticut Commercial Clinical Policy

Anthem Blue Cross Connecticut RAD.00063 Magnetization-Prepared Rapid Acquisition Gradient Echo Magnetic Resonance Imaging (MPRAGE MRI) Form

Effective Date

06/28/2023

Last Reviewed

05/11/2023

Original Document

  Reference



This document addresses magnetization-prepared rapid acquisition gradient echo (MPRAGE) magnetic resonance imaging (MRI).

Position Statement

Investigational and Not Medically Necessary:

The use of magnetization-prepared rapid acquisition gradient echo magnetic resonance imaging (MPRAGE MRI) is considered investigational and not medically necessary for all indications.