Cerebral Perfusion Studies

Aetna covers cerebral CT perfusion (CPT 0042T) as a supplement to non‑contrast head CT or when MRI is unavailable/contraindicated, and cerebral MRI perfusion (diffusion‑ or perfusion‑weighted, including DSC/DCE/ASL) for evaluation of acute ischemia and for distinguishing glioma recurrence from pseudoprogression. Coverage requires appropriate acute ischemia diagnosis codes (I63.00–I63.9, I65.01–I65.9, I66.01–I66.9) and excludes perfusion studies for brain‑death confirmation, lung lesion differentiation, vasospasm/delayed ischemia after aneurysmal SAH, and various glioma characterization indications as experimental/investigational.

"Cerebral computed tomography (CT) perfusion studies for the emergent evaluation of acute cerebral ischemia (acute stroke) when either of the following criteria is met: CT perfusion studies will be ..."

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