Cardiac Imaging Guidelines

This policy covers cardiac imaging services — including echocardiography, nuclear cardiac imaging, cardiac CT/CTA/CAC, cardiac MRI, cardiac PET, diagnostic heart catheterization and pulmonary vascular imaging — for evaluation of CAD, ischemia (including silent ischemia), heart failure, cardiomyopathies (e.g., Fabry’s, Takotsubo, hibernating myocardium), syncope, cancer therapy–related cardiac dysfunction and related cardiac symptoms. Major limitations/requirements include a recent clinical evaluation and ECG (typically within 60 days), availability of prior test reports, that imaging must be expected to affect management, use of a pre‑test probability grid for stress imaging, exercise tolerance and an interpretable ECG for ETT, and physician review for atypical presentations.

"$>$ Stress Testing in patients for Non-Cardiac Transplant"

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