BlueCross BlueShield Tennessee to expand cardiac PET coverage
BlueCross BlueShield of Tennessee announced it will expand Medicare coverage for cardiac PET, according to the Society for Nuclear Medicine and Molecular Imaging (SNMMMI). The change will take effect later this year.
The announcement comes more than two weeks days after SNMMI and the American Society of Nuclear Cardiology (ASNC) addressed a letter to the insurer supporting its proposed coverage expansion.
Below are the expansions to cardiac PET coverage:
- PET is now classified as “medically necessary” so long as necessary medical criteria is met.
- The use of PET for the diagnosis or evaluation of all other non-oncological and/or non-cardiac conditions or diseases is investigational.
- PET use is deemed “medical appropriate” if any of the following conditions are met: imaging of the adult or pediatric brain for the preoperative planning of epilepsy surgery; adult abdominal lymph node lesion imaging if previous biopsy is negative or inconclusive; pediatric mediastinal mass imaging before biopsy in suspected lymphoma patients or in those with evidence of tracheal compression.
Matt joined Chicago’s TriMed team in 2018 covering all areas of health imaging after two years reporting on the hospital field. He holds a bachelor’s in English from UIC, and enjoys a good cup of coffee and an interesting documentary.