PET for Perfusion of the Heart

PET myocardial perfusion imaging using FDA‑approved Rubidium‑82 (effective 1995-03-14) or Ammonia N‑13 (effective 2003-10-01) is covered for diagnosis and management of known or suspected coronary artery disease when performed in place of (not in addition to) SPECT or when performed after a documented inconclusive SPECT and necessary to determine medical or surgical intervention. Medical records must document the prior test and clinical necessity; specific billing code documentation requirements apply for claims around the July 1, 2001 transition.

"Rubidium-82 (Rb-82) PET at rest or with pharmacologic stress is covered for noninvasive myocardial perfusion imaging to diagnose or manage patients with known or suspected coronary artery disease w..."

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