Addendum to eviCore Guidelines

This addendum updates eviCore coding effective 1/1/2020 by adding/revising CPTs—notably radiopharmaceutical localization/SPECT and SPECT/CT (78800–78804, 78830–78832), cardiac PET (78429–78434), sacroiliac procedures (64451, 64625), updated PT/OT codes, and device/procedure codes—while removing older/deleted codes (e.g., 78205, 78320, 78805–78807, G0365) which should no longer be billed. It does not change clinical coverage or documentation requirements; existing eviCore guideline clinical criteria, limitations, prior authorization and documentation rules in the referenced sections continue to apply, and billing with replaced/deleted CPTs may be non‑covered or denied.

"Radiopharmaceutical localization imaging (planar and SPECT) and SPECT/CT (CPT 78800-78804, 78830-78832) for tumor localization, inflammatory process localization, or distribution of radiopharmaceut..."