Anthem Blue Cross Connecticut RAD.00061 PET/MRI Form
Procedure is not covered
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.