Premera Blue Cross of Washington prior authorization 78492

Premera Blue Cross of Washington prior authorization for 78492: Myocardial imaging, positron emission tomography (PET), perfusion study (including ventricular wall motion[s] and/or ejection fraction[s], when performed); multiple studies at rest and stress (exercise or pharmacologic) These criteria do not imply or guarantee approval.

Code: 78492
Description: Myocardial imaging, positron emission tomography (PET), perfusion study (including ventricular wall motion[s] and/or ejection fraction[s], when performed); multiple studies at rest and stress (exercise or pharmacologic) These criteria do not imply or guarantee approval.
Source: Clinical Review by Code List PBCWA, Pg 433 Original policy

Premera Blue Cross of Washington prior authorization

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