Anthem Blue Cross Connecticut RAD.00061 PET/MRI Form

Effective Date

09/27/2023

Last Reviewed

08/10/2023

Original Document

  Reference



This document addresses combination positron emission tomography/magnetic resonance imaging (PET/MRI) technology with dedicated scanners, such as the Biograph mMR System (Siemens Medical Solutions U.S.A., Inc., Malvern, PA). The Biograph mMR System is a combined Magnetic Resonance Diagnostic Device (MRDD) and Positron Emission Tomography (PET) scanner that provides a combined approach to imaging anatomical, functional and biochemical characteristics of disease.

Position Statement

Investigational and Not Medically Necessary:

The use of combined PET/MRI imaging technology is considered investigational and not medically necessary for all indications.