Cardiovascular Nuclear Medicine

Cardiovascular nuclear imaging (perfusion and ventricular function studies) is covered for diagnostic evaluation of angina and chest pain with uninterpretable ECG, assessment of coronary anomalies, pre- and post-revascularization evaluation, detection of CAD in new heart failure or LV dysfunction, differentiation of ischemic vs non-ischemic cardiomyopathy when catheterization is not planned, device candidacy requiring accurate EF, surveillance during cardiotoxic chemotherapy, and selected preoperative risk assessments (patients with poor functional capacity or intermediate/high CAD likelihood). Coverage excludes screening studies in asymptomatic patients without abnormal exam or testing, duplicative or non-management–changing tests, perfusion after diagnostic PET, infarct scintigraphy when MI already confirmed by ECG/enzymes, and most preoperative testing for low-risk surgery or within 1 year after a normal test in asymptomatic patients; special documentation and supervision requirements, and limits on same-day blood-pool plus perfusion imaging apply.