Valvular heart disease when the following criterion is met:Īfter it has been determined that echocardiogram and Doppler studies are inconclusive or expected to be nondiagnostic orĭetection and localization of inducible myocardial perfusion deficits or inducible contractile dysfunction detection or quantification of the extent of acute or chronic myocardial infarction differentiation of recent from remote myocardial infarction or.Cardiac function, morphology, and structure when the following criterion is met :Īfter it has been determined that echocardiogram is inconclusive or expected to be non-diagnostic orĪtrial fibrillation, for assessing left atrial structure and function, for detecting thrombi in the left atrial appendage when echocardiogram is inconclusive, and for identifying pulmonary vein anatomy prior to or after electrophysiology procedures orįor example: acquired and congenital abnormalities of the superior or inferior vena cavae, pulmonary vein system, or portal venous system (e.g., vena caval thrombus, differentiation of tumor thrombus and blood clot of the vena cava, superior vena caval syndrome, superior vena caval invasion or encasement by lung or mediastinal tumors, diagnosis of Budd-Chiari syndrome, and diagnosis of other caval anomalies) or.Assessment of right ventricular cardiomyopathy/dysplasia orįor example: ventricular septal defect, atrial septal defect, tetralogy of Fallot, transposition of the great arteries, pulmonary atresia, obstruction to the right ventricular outflow tract, other complex cyanotic heart disease, pulmonary venous anomalies, after surgery for correction of congenital heart disease or.Pathology involving surrounding structuresįor example: to evaluate intrinsic abnormalities of the pulmonary arteries, including central thrombi, aneurysms, stenoses, occlusions, dissection, and extra-vascular disease involving the pulmonary arteries or.External or internal masses, pathology of lung and pleuraįor example: chest wall and mediastinal tumor invasion of the lung and pleura, masses (e.g., lipoma), intracavity tumors, and differentiation of tumor from thrombus, assessment of vascular invasion, hilar assessment, and pericardial/myocardial invasion, pleural diseases or.Aetna considers magnetic resonance imaging (MRI) of the cardiovascular system medically necessary for the indications listed below, in accordance with guidelines developed by the American College of Cardiology Foundation, American College of Radiology (ACR) and the American Heart Association (AHA):įor example: abnormal aortic contour or size on chest X-ray, differentiation of mediastinal mass versus vascular abnormality, to rule out aortic dissection, aneurysm, leaking thoracic aneurysm, exclude aortic source of peripheral embolization, Sinus Valsalva aneurysm, Marfan's syndrome and aorta annular ectasia, after therapy of aortic dissection of aortic arch anomalies, coarctation, following aortic angioplasty, periaortic abscess or infection orįor example: to assess pericardial thickness and detection of metastases, for diagnosing pericardial cysts, pericarditis and constriction, for diagnosing effusion and tamponade or
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