Transthoracic Echocardiography (TTE)

Transthoracic echocardiography (TTE) is covered when used to evaluate cardiac structure and function in specific clinical situations including heart failure/cardiomyopathy, valvular disease, acute ischemia, transplant monitoring, cardiotoxic chemotherapy monitoring, pericardial disease, congenital heart disease, suspected embolic sources, cardiac masses, critical/trauma care, and when stress imaging or contrast are clinically indicated. Routine screening and numerous routine annual reassessments in stable, asymptomatic patients (specific scenarios enumerated) are not covered; additional documentation, physician orders, and meeting technical/reporting standards are required. Specific frequency rules apply for transplant monitoring, cardiotoxic chemotherapy, and CAMZYOS (mavacamten) REMS-related echocardiography, and studies that fail to meet documentation or technical completeness (including inappropriate use of limited-capability scanners or undocumented Doppler/stress imaging) may be denied.