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

This policy addresses myocardial sympathetic innervation imaging, with or without SPECT (e.g., I-123 iobenguane/MIBG; HCPCS A9582), used to assess cardiac autonomic function. Anthem deems this service investigational/experimental and not medically necessary for all indications, including evaluation of heart failure; therefore, it is not covered under any circumstance, with no exceptions or covered indications.

"Myocardial sympathetic innervation imaging is consideredinvestigational and not medically necessaryfor all indications, including the evaluation of heart failure."

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