78492 prior authorization | Anthem Blue Cross and Blue Shield New Hampshire
78492, Myocardial imaging, positron emission tomography (PET), perfusion study (including ventricular wall motion[s] and/or ejection fraction[s], when performed); multiple studies at rest and 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
- 78492
- Description
- Myocardial imaging, positron emission tomography (PET), perfusion study (including ventricular wall motion[s] and/or ejection fraction[s], when performed); multiple studies at rest and stress (exercise or pharmacologic)
- Source
- New Hampshire Precertification List, Pg 154 Original policy
Anthem Blue Cross and Blue Shield New Hampshire prior authorization