B-Type Natriuretic Peptide (BNP)

BNP (total or N-terminal) testing is covered to help establish or exclude congestive heart failure and assess severity in patients presenting with acute dyspnea when used alongside clinical evaluation and standard diagnostics, and for risk stratification when measured in the first few days after an acute coronary event. BNP is not covered as a stand-alone test, for routine screening without documented clinical suspicion of CHF, or for ongoing monitoring/management or tailoring of CHF therapy; testing is generally limited to no more than four times per year.

"BNP (total or N-terminal) measurement is medically reasonable and necessary to establish or exclude diagnosis and assess severity of congestive heart failure (CHF) in patients presenting with acute..."

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