Links to Commercial Payer Policies

Other Commercial Payer Policies

Aetna – Magnetic Resonance Imaging of the Cardiovascular System - Cardiac MRI

 

Aetna – Cardiac CT, Coronary CT Angiography and Calcium Scoring

 

Aetna – Magnetic Resonance Angiography (MRA) and Magnetic Resonance Venography (MRV)

 

Aetna – Positron Emission Tomography (including cardiac)

 

Anthem/Wellpoint

Positron Emission Tomography (PET) and PET/CT Fusion

 

Anthem/Wellpoint –
Contrast-Enhanced Cardiac Computed Tomography Angiography (CTA) and Cardiac Magnetic Resonance Angiography (MRA)

 

Blue Cross of California –

Contrast-Enhanced Cardiac Computed Tomography Angiography (CTA) and MRA (Cardiac Magnetic Resonance Angiography (MRA)

 

Blue Cross of California – PET and PET/CT Fusion

 

Blue Cross and Blue Shield of Oklahoma – CTA

 

Blue Cross and Blue Shield of Oklahoma – MRA

 

Blue Cross and Blue Shield of Oklahoma – PET
(all applications including cardiac)

 

Cigna – Cardiovascular Magnetic Resonance (CMR)

 

Cigna – Computed Tomography Angiography (CTA) 

 

Cigna – Magnetic Resonance Angiography (MRA)

 

Cigna – Positron Emission Tomography (PET) - including cardiac

 

Horizon Blue Cross and Blue Shield of New Jersey 
Medical Policy Manual

 

CareCore National
PHYSICIAN GUIDELINES – Current, Evidence-based Recommendations Regarding Cardiac Imaging

 

CareCore National – CT/CTA Clinical Certification Request Form

 

CareCore National – MR/MRA Clinical Certification Request Form

 

CareCore National – PET Scan Precertification Form

 

CareCore Cardiology
CareCore Cardiology Management Cardiac CT Specialty Center, physician credentialing requirements

 

National Imaging Associates – Diagnostic Imaging Guidelines

 

 


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