Prior Auth Required

78434 - Absolute quantitation of myocardial blood flow (AQMBF), positron emission tomography (PET), rest and Prior Authorization Required Only if POS is 22 (On Campus-Outpatient Hospital)

This procedure appears on the selected insurer prior authorization source.

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Prior authorizationPrior Auth Required
Procedure / ServiceAbsolute quantitation of myocardial blood flow (AQMBF), positron emission tomography (PET), rest and Prior Authorization Required Only if POS is 22 (On Campus-Outpatient Hospital)
Procedure / Service Description

Code NAME/DESCRIPTION COMMENTS - study (including ventricular wall motion[s] and/or ejection fraction[s], when performed), dual radiotracer (eg, myocardial viability); with concurrently acquired computed tomography transmission scan 78434 Absolute quantitation of myocardial blood flow (AQMBF), positron emission tomography (PET), rest and Prior Authorization Required Only if POS is 22 (On Campus-Outpatient Hospital) pharmacologic stress (List separately in addition to code for primary procedure) 78451 Myocardial perfusion imaging, tomographic (SPECT) (including attenuation correction, qualitative or Prior Authorization Required Only if POS is 22 (On Campus-Outpatient Hospital)

Likely documents
  • Confirm benefit details
  • Submit clinical notes if requested by the plan
Next actions
  • Confirm the current plan policy before submission.
  • Use the insurer authorization workflow for this listed code.