Question:

Do insurers require an inconclusive SPECT myocardial perfusion scan prior to performing a PET myocardial perfusion scan?

Answer:

You will need to check the individual payer’s policy. For instance, Medicare’s policy states that a PET myocardial perfusion scan may be performed in place of a SPECT scan or after an inconclusive SPECT scan. Aetna’s policy is similar except that it states PET may be performed in place of SPECT “in persons with conditions that may cause attenuation problems with SPECT (obesity (BMI greater than 40), large breasts, breast implants, mastectomy, chest wall deformity, pleural or pericardial effusion)…”

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