Cardiac Imaging Guidelines

This policy covers cardiac imaging modalities—including echocardiography, nuclear cardiac imaging, cardiac CT/CTA/CAC, cardiac MRI, cardiac PET, and diagnostic heart catheterization—used to evaluate symptoms and conditions such as chest pain/angina (and equivalents), congestive heart failure, cardiac trauma, adult congenital heart disease, ARVD/ARVC, and cancer therapeutics–related cardiac dysfunction. Major limitations/requirements include a clinical evaluation and recent ECG within 60 days, review of prior non‑advanced testing and stress-test results, expectation that imaging will affect management (with optimized medical therapy where applicable), physician review for atypical presentations, and avoidance of stress imaging when invasive angiography has already been planned.

"Documentation of severity: moderate to severe or severe mitral regurgitation."

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