Cardiac Imaging Guidelines

This policy covers cardiac imaging services—including cardiac MRI/MRA (including stress MRI), cardiac PET studies (perfusion, metabolic, AQMBF, FDG PET/CT), and diagnostic heart catheterization procedures (left, right, combined)—for evaluation of ischemia, coronary syndromes, adult congenital heart disease, and other specified cardiac conditions. Coverage is limited to patients whose symptoms or presentations are among those specifically addressed by the tool (e.g., unstable/active coronary syndromes); atypical presentations require physician review, a recent clinical evaluation and appropriate prior testing (ECG, chest x‑ray, echocardiography, prior stress tests), and imaging is not indicated when results will not affect clinical management.

"References (CD-7)"

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