78491 prior authorization | Anthem Blue Cross and Blue Shield New Hampshire

78491, Myocardial imaging, positron emission tomography (PET), perfusion study (including ventricular wall motion[s] and/or ejection fraction[s], when performed); single study, at rest or stress (exercise or pharmacologic), is on the Anthem Blue Cross and Blue Shield New Hampshire prior authorization list. Not a coverage or referral decision.

Code: 78491
Description: Myocardial imaging, positron emission tomography (PET), perfusion study (including ventricular wall motion[s] and/or ejection fraction[s], when performed); single study, at rest or stress (exercise or pharmacologic)
Source: New Hampshire Precertification List, Pg 154 Original policy

Anthem Blue Cross and Blue Shield New Hampshire prior authorization

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