LCDActive
B-type Natriuretic Peptide (BNP) Testing
L34038
Effective: October 1, 2019
Updated: December 31, 2025
Policy Summary
BNP (or NT-proBNP) testing is covered as an adjunctive diagnostic tool to help establish, exclude, or differentiate congestive heart failure—particularly in patients with acute dyspnea or when other tests are equivocal—only when used together with clinical findings and standard diagnostic studies. BNP testing is not covered for standalone use, routine screening, serial monitoring or management-guided treatment of CHF, and use for ACS risk stratification is not covered because it has not been shown to alter patient management.
Coverage Criteria Preview
Key requirements from the full policy
"BNP (or NT-proBNP) measurement is reasonable and necessary when used with medical history, physical exam, laboratory studies, and chest x-ray to diagnose or differentiate congestive heart failure i..."
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