B-type Natriuretic Peptide (BNP) Testing

BNP testing is covered when used alongside clinical assessment and standard diagnostics to differentiate cardiac versus non-cardiac causes of acute dyspnea, to distinguish decompensated CHF from COPD exacerbation in patients with both conditions, to establish prognosis or disease severity in chronic heart failure, to guide GDMT dosing in select euvolemic patients enrolled in HF management programs, and to guide therapy in amyloidosis. BNP is not intended as a stand-alone test and results must be interpreted with awareness of confounding conditions (e.g., ischemia, infarction, renal insufficiency); the LCD does not specify numeric frequency limits.

"BNP testing is reasonable to distinguish cardiac causes of acute dyspnea (congestive heart failure) from pulmonary or other non-cardiac causes when used with other clinical data."

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