B-type Natriuretic Peptide (BNP) Testing

BNP testing is covered when used in combination with other clinical information to distinguish cardiac causes of acute dyspnea, to differentiate decompensated CHF from COPD exacerbation in patients with both conditions, and for early (first few days) risk stratification after acute coronary syndromes. BNP testing must not be used as a stand-alone diagnostic test, and serial BNP measurements for monitoring or guiding therapy in chronic heart failure are not covered. Results may be confounded by conditions such as ischemia, infarction, and renal insufficiency and must be interpreted with supporting diagnostic data (history, exam, labs, chest x-ray, ECG).

"BNP testing is reasonable and necessary, when used with other medical data, to distinguish a cardiac cause of acute dyspnea from pulmonary or other non-cardiac causes."

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