Cardiovascular Nuclear Medicine

Cardiovascular nuclear medicine (perfusion and ventricular function imaging) is covered for diagnostic evaluation of angina, chest pain with uninterpretable ECGs, risk assessment in selected patients with known coronary disease (no revascularization within 2 years), new-onset heart failure or LV dysfunction, pre/post revascularization assessment, infarct evaluation when ECG/enzyme testing is non-diagnostic, ventricular function assessment for device candidacy or cardiotoxic chemotherapy, and selected preoperative risk assessments when results will change management. Routine screening in asymptomatic patients, duplicative tests, tests that will not affect management, post-PET perfusion studies, and certain preoperative tests (low-risk surgery or within 1 year after a normal test for high-risk surgery) are not covered; certain code or isotope combinations are restricted and allowed only when laboratories document specific equipment and capabilities.

"Myocardial perfusion imaging is indicated to assess the functional and prognostic importance of angina."