2027 Radiology CPT Updates: New MRA Head and Neck Coding and Reporting Guidelines
A patient gets an MRA of the head and neck in a single session. For years, that meant two charges, and the combination became common enough that CPT reviewers flagged it. On January 1, 2027, the structure changes: three new codes combine the two regions, and every existing MRA head and neck code now includes image postprocessing.
For radiologists, coders, and billing teams, that means reviewing charge master entries, contrast documentation, and any separate postprocessing charges before the first 2027 claim goes out. This guide explains what is verified, what is not yet public, and how to prepare. Descriptors are paraphrased, so use the licensed CPT 2027 codebook for exact language.
In this guide What is changing • The MRA codes • Postprocessing • Contrast • Documentation • Common mistakes • RCM impact • Implementation checklist • FAQ |
What Is Changing in Radiology CPT Coding for 2027?
The AMA released CPT 2027 on September 9, 2026, effective January 1, 2027. For MRA of the head and neck, the changes are below.
The first three rows are verified from public sources. Revised codes keep their existing numbers, and the combined codes are new, not revisions.
Understanding the New MRA Head and Neck CPT Codes
Final numbers for the combined codes are not public yet CMS’s proposed 2027 rule used placeholder identifiers for the three combined codes, and our research found no public source with the final numbers. Placeholders are not billable codes. Take the final numbers and descriptors from the CPT 2027 codebook or your encoder before updating the charge master. | ||||
CPT code | Description (paraphrased) | Contrast scenario | 2027 status | Reporting consideration |
70544 | MRA head, including image postprocessing | Without contrast | Revised | Postprocessing now included |
70545 | MRA head, including image postprocessing | With contrast | Revised | Postprocessing now included |
70546 | MRA head, including image postprocessing | Without, then with contrast and further sequences | Revised | Postprocessing now included |
70547 | MRA neck, including image postprocessing | Without contrast | Revised | Postprocessing now included |
70548 | MRA neck, including image postprocessing | With contrast | Revised | Postprocessing now included |
70549 | MRA neck, including image postprocessing | Without, then with contrast and further sequences | Revised | Postprocessing now included |
Combined 1 (number: see CPT 2027) | MRA head and neck, including image postprocessing | Without contrast | New | Replaces separate head and neck reporting for one session |
Combined 2 (number: see CPT 2027) | MRA head and neck, including image postprocessing | With contrast | New | As above |
Combined 3 (number: see CPT 2027) | MRA head and neck, including image postprocessing | Without contrast in one or both regions, followed by contrast and further sequences in one or both | New | As above |
Descriptor details come from the CPT Editorial Panel text as reproduced in ASNR’s summary. CMS described the combined codes as created to bundle head and neck MRA. Whether any two-code reporting remains permitted is set by CPT 2027 instructions and edits, so do not assume it. Confirm there.
Want a second look at your MRA charge logic? Request a billing and RCM review with Sirius Solutions Global before January 1. |
Image Postprocessing and Its Impact on MRA Reporting
Image postprocessing means processing the acquired angiographic images, such as reformatting or reconstruction, so they can be interpreted. Because all six existing descriptors now include it, a practice that reported postprocessing separately should review that logic. Vendor guides such as Radiology Billing Solutions warn that adding 3D rendering codes could become a bundling problem. Check the CPT 2027 instructions and current NCCI edits before reporting anything separately.
Documentation checklist: postprocessing Examination and region • That postprocessing was performed • Radiologist interpretation of the processed images • Final report consistent with the charge • Any payer-specific requirement |
Contrast Administration and MRA Code Selection
Examination scenario | Coding consideration | Documentation focus |
Head only, without contrast | Head code for no contrast | Region and contrast status |
Head only, with contrast | Head code for contrast | Contrast agent and timing |
Head only, without then with | Head code for the combined sequence | Both phases and further sequences |
Neck only (three contrast scenarios) | Matching neck code | Region and contrast status |
Head and neck, same contrast status | Evaluate the matching combined code | Both regions and contrast |
Head and neck, contrast differs by region | The third combined code addresses contrast in one or both regions; confirm exact rules in CPT 2027 | Which region received which phase |
Educational navigation aid, not an automated coding decision. Follow the official CPT guidelines.
Documentation Requirements Radiology Practices Should Review
☐ Examination performed
☐ Anatomical region examined
☐ Contrast administration status
☐ Sequence details where relevant
☐ Image postprocessing
☐ Radiologist interpretation
☐ Final report
☐ Medical necessity
☐ Order and supporting documentation
☐ Applicable payer requirements
Documentation must support the service actually performed and reported.
Common MRA Coding and Billing Mistakes
Mistake | Potential impact | How to reduce the risk |
1. Using outdated CPT descriptors | Wrong code on 2027 dates of service | Load the CPT 2027 set before January 1 |
2. Wrong contrast scenario | Mismatched code and report | Cross-check the report against the descriptor |
3. Separate exams where combined rules apply | Edit or denial risk | Confirm CPT 2027 and NCCI instructions |
4. Missing postprocessing documentation | Support questioned | Add postprocessing to the report workflow |
5. Report and claim disagree | Rework | Pre-submission validation |
6. Incorrect modifiers | Edit or payment issues | Use modifiers only when rules and documentation support them |
7. Ignoring payer policy | Payer-specific denials | Verify each payer’s 2027 policy |
8. Not updating software and references | Rejected claims | Test the charge master and edits |
Errors do not automatically cause denials, but each raises review risk.
How the 2027 Radiology Updates Can Affect Revenue Cycle Management
RCM area | Potential challenge | Recommended action |
Claim accuracy | Old two-code logic persists | Update claim scrubber rules |
Charge capture | Separate head and neck charges | Redesign charge capture |
Coding audits | New descriptors misread | Audit early 2027 claims |
Denial prevention | Bundling edits | Review edits for new codes |
Medical necessity | Order does not match exam | Compare orders and exams |
Documentation quality | Postprocessing not noted | Update report templates |
A/R follow-up | Early denials sit | Prioritize MRA claims |
Software and training | Staff use old references | Update systems and train |
Payer policy | Rules differ by payer | Verify before go-live |
2027 Radiology CPT Implementation Checklist
☐ Obtain the finalized 2027 CPT code references
☐ Review revised MRA head and neck descriptors
☐ Verify new combined MRA head and neck codes
☐ Update coding and billing software
☐ Review contrast documentation workflows
☐ Educate radiologists and coding staff
☐ Update charge capture procedures
☐ Review payer-specific billing guidance
☐ Test claim workflows before implementation
☐ Conduct post-implementation coding audits
☐ Monitor denial trends and claim accuracy
Start before January 1 Charge master, edits, and report templates take time to change. Preparing in November and December leaves room to test. |
How Sirius Solutions Global Supports Radiology Billing
Sirius Solutions Global offers medical billing and claims management, coding support, eligibility verification, denial management, prior authorization support, A/R follow-up, billing audits, revenue leakage identification, and credentialing and re-credentialing. AI-assisted processes combined with human verification can improve workflow oversight, which matters when code structures change. Radiology practices benefit from billing teams that understand procedure-specific coding, documentation, and payer requirements. We do not guarantee outcomes or claim results specific to radiology.
How Ready Is Your Billing Process?
Question | Yes | No |
Have you updated your CPT references for 2027? | ☐ | ☐ |
Has staff been trained on the MRA changes? | ☐ | ☐ |
Are documentation workflows reviewed for postprocessing and contrast? | ☐ | ☐ |
Has your billing software and charge master been updated? | ☐ | ☐ |
Have you reviewed payer policies? | ☐ | ☐ |
Do you audit claims for coding accuracy? | ☐ | ☐ |
Yes answers | Result |
0–2 | Several areas may need attention before January 1 |
3–4 | Some preparation is in place; close the remaining gaps |
5–6 | Most areas are addressed; keep monitoring |
Informal operational readiness assessment, not a compliance certification.
Frequently Asked Questions
▸ What are the major radiology CPT updates for 2027?
Revised MRA head and neck codes, three new combined MRA codes, and changes to prostate biopsy and intraosseous fiducial marker services, per one summary. Check the CPT 2027 codebook.
▸ What are the new MRA head and neck CPT codes?
Three combined codes for without contrast, with contrast, and without then with contrast. Their final numbers are in the CPT 2027 codebook.
▸ What happened to 70544, 70545, and 70546?
They remain and are revised to include image postprocessing.
▸ What happened to 70547, 70548, and 70549?
They remain and are revised the same way.
▸ How are combined head and neck MRAs reported in 2027?
With a combined code that matches the contrast scenario. Confirm the exact rules in CPT 2027.
▸ Does image postprocessing affect reporting?
Yes. It is now part of the descriptors, so review any separate postprocessing charges.
▸ How does contrast affect code selection?
Codes distinguish without, with, and without-then-with scenarios, and the third combined code addresses contrast in one or both regions.
▸ When do the changes take effect?
January 1, 2027.
▸ How can practices prepare?
Update references and software, train staff, review documentation, check payer policies, and audit early claims.
▸ How can a billing company help?
With code mapping, claim review, denial analysis, and A/R follow-up.
Disclaimer: This article is educational, published by Sirius Solutions Global, and is not coding, legal, or compliance advice. CPT® is a registered trademark of the AMA, and descriptors are paraphrased. Sirius Solutions Global is not affiliated with the AMA, ACR, ASNR, or CMS. Nothing here guarantees coverage, reimbursement, or audit outcomes.
