Does A9582 require prior authorization?

Yes, A9582 requires prior authorization (high confidence). Code explicitly requires prior authorization.

What is the Medicare reimbursement rate for A9582?

Medicare facility rate: N/A. Non-facility rate: N/A. Work RVU: 0.00.

HCPCS/CPT

Prior Auth Required

Code explicitly requires prior authorization (high confidence)

Work RVU

0.00

Facility

N/A

Non-Facility

N/A

Documentation that the marketed version of the MIBG test (and any scoring algorithms) was used.
Description of the reference standard used for comparison must be provided.
Documentation of patient/sample clinical characteristics.
Documentation of patient/sample selection criteria.

Use as a prognostic marker in individuals with heart failure to identify those at risk of 1-year mortality
Use as a prognostic marker in individuals with heart failure to identify those at risk of 2-year mortality
Use to guide treatment decisions for patients with heart failure
Use to monitor the effectiveness of heart failure treatments
Use of Iodine-123 MIBG imaging to assess myocardial sympathetic innervation in individuals with heart failure.
Detection of primary or metastatic pheochromocytoma or neuroblastoma as an adjunct to other diagnostic tests (FDA-approved indication for AdreView/lobenguane I-123).

ANTHEM-RAD.00064, RAD.00064 Myocardial Sympathetic Innervation Imaging with or without Single-Photon Emission Computed Tomography (SPECT)

RAD604.012, Myocardial Sympathetic Innervation Imaging in Individuals With Heart Failure

BCBSIL-RAD604.012, Myocardial Sympathetic Innervation Imaging in Individuals With Heart Failure

BCBSMT-RAD604.012, Myocardial Sympathetic Innervation Imaging in Individuals With Heart Failure

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