T-Wave Alternans

Aetna covers microvolt T‑wave alternans (MTWA) testing using the spectral analytic method (CPT 93025) as medically necessary only for evaluation of patients at risk of sudden cardiac death who meet criteria for implantable cardioverter‑defibrillator (ICD) placement (covered ICD‑10s include certain cardiomyopathies I42.x, cardiac arrest I46.2‑I46.9, and paroxysmal tachycardia I47.x), and considers MTWA experimental/investigational (not covered) for all other indications (e.g., ACS risk assessment, reversible ischemia without structural heart disease, evaluation of non‑pathological preterm infants). Key requirements: testing is covered only if ICD‑selection criteria are met, and MTWA is not covered for guiding anti‑arrhythmic therapy.

"CPT/usage-specific limitations: CPT 93025 is noted as '[not covered for the diagnosis and risk assessment of acute coronary syndrome and guiding anti-arrhythmic therapy]'."