S3902 — Ballistocardiogram
HCPCS/CPT
Prior Authorization
No Prior Auth Required
Code is covered without prior authorization (high confidence)
Medicare Pricing
Work RVU
0.00
Facility
N/A
Non-Facility
N/A
Documentation Required
- None specified in the policy.
- Related note (not a documentation requirement from payer): "The FDA indications for use states that the device is not intended as a sole means of diagnosis and that interpretation of heart sounds with the Zargis Acoustic Cardioscan are only significant when used in conjunction with physician over-read as well as consideration of all other patient data."
Key Coverage Criteria
- None. (Policy does not list any covered indications for these technologies.)
- Implicit from policy: no covered diagnoses — the policy states these interventions are experimental and investigational and therefore not established as effective for clinical use.
1 Active Policy
AETNA-CPB-0692 — Acoustic Heart Sound Recording and Computer Analysis
Related Codes
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