Prior Auth Required

78496 - Cardiac blood pool imaging, gated equilibrium, single study, at rest, with right ventricular ejection fraction by Prior Authorization Required Only if POS is 22 (On Campus-Outpatient Hospital)

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Procedure / ServiceCardiac blood pool imaging, gated equilibrium, single study, at rest, with right ventricular ejection fraction by Prior Authorization Required Only if POS is 22 (On Campus-Outpatient Hospital)
Procedure / Service Description

Myocardial imaging, positron emission tomography (PET), perfusion study (including ventricular wall motion[s] - 78494 Cardiac blood pool imaging, gated equilibrium, SPECT, at rest, wall motion study plus ejection fraction, with or Prior Authorization Required Only if POS is 22 (On Campus-Outpatient Hospital) without quantitative processing 78496 Cardiac blood pool imaging, gated equilibrium, single study, at rest, with right ventricular ejection fraction by Prior Authorization Required Only if POS is 22 (On Campus-Outpatient Hospital) first pass technique (List separately in addition to code for primary procedure) 78499 Unlisted cardiovascular procedure, diagnostic nuclear medicine

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.