Cardiac Radionuclide Imaging

Cardiac radionuclide imaging (MPI/SPECT, PET Rb-82, and cardiac blood pool imaging/MUGA) is covered for evaluation and management of coronary artery disease, assessment of myocardial viability, select evaluation in AMI and unstable angina, congenital coronary anomalies, post-transplant coronary arteriopathy/rejection, and for baseline and monitoring of cardiac function when cardiotoxic chemotherapy is used. PET Rb-82 is covered when used instead of SPECT or following an inconclusive SPECT with documented medical necessity; several radionuclide procedures (ambulatory radionuclide monitoring, anti-myosin, thrombi imaging, cardiac adrenergic nerve imaging) are investigational and not covered. Pharmacologic stress agents are allowed only when exercise is not possible or target heart rate cannot be achieved and have defined contraindications, and all imaging requires appropriate physician supervision documented in the medical record.

"Myocardial perfusion imaging (MPI/SPECT) is covered for diagnosis and management of coronary artery disease (CAD), including evaluation of atypical chest pain, abnormal or suspected false-positive ..."