Insurance provider Aetna will now pay for cardiac PET/CT imaging after reversing its noncoverage policy, the Society for Nuclear Medicine and Molecular Imaging (SNMMI) recently reported.
Aetna considered hybrid PET/CT (CPT codes 78429-78431, 78433) "experimental and investigational," yet changed its tune after receiving a letter from SNMMI and the American Society of Nuclear Cardiology (ASNC) stating that policy is “inconsistent with standards and practice for cardiac PET imaging across the United States," according to SNMMI.
In 2016, SNMMI and ASNC offered imaging guidelines and procedure standards published in their journals that detailed the quality components required to perform PET nuclear cardiology procedures. The publication of these peer-reviewed documents validated the role of cardiac PET and led to reimbursement by the U.S. Centers for Medicare and Medicaid Services and most other payers for procedures with category I codes.
Aetna's policy had been on the books since 2005.
