Cardiac PET using fluorodeoxyglucose (FDG) for myocardial viability assessment in a patient that: a. has moderate to severe ischemic left ventricular dysfunction (left ejection less than or equal to 40%) despite maximal medical therapy; and b. is a suitable candidate for a cardiac revascularization procedure or cardiac transplantation.
PET is an insured service for the clarification of myocardial viability when:
a. a previous myocardial imaging assessment has been rendered, using another modality (e.g. SPECT using thallium, MIBI or dobutamine stress echocardiography) and the result of the previous imaging assessment was equivocal or demonstrated insufficient viable myocardium; or
b. a patient with a left ventricular ejection fraction less than 35% and known multi-vessel coronary disease determined by coronary angiography urgently needs an assessment of myocardial viability.
Examples of other modalities for assessing viability include SPECT imaging using myocardial perfusion agents such as thallium, MIBI or tetrofosmin, or dobutamine stress echocardiography.
Submit claims for the professional component of a PET scan using the “C” suffix.