Echocardiography for Myocardial Perfusion

This policy covers use of FDA‑approved ultrasound enhancing agents (UEAs) for left ventricular opacification (LVO) by IV injection when unenhanced echocardiography fails to adequately visualize endocardial borders needed for accurate left ventricular measurements. Off‑label UEA use for myocardial perfusion or viability is acknowledged and may be subject to LCD criteria, but non‑FDA‑approved UEAs and use of UEAs for perfusion solely as a screening test are not covered.

"Use of FDA‑approved ultrasound enhancing agents (UEAs) for left ventricular opacification (LVO) via IV injection when unenhanced transthoracic echocardiography cannot adequately visualize endocardi..."

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