78491 coverage policies: Medicare and commercial payers

9 active Medicare policies list 78491, and 15 commercial payer policies list it. See each policy's status for the code and its official source. Listing a code is not a coverage decision: read each policy’s source for the requirements that apply.

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Medicare policies listing 78491

LCD · PALMETTO-JJ-L33457

Cardiac Radionuclide Imaging

JJ · Effective Oct 1, 2015

LCD · PALMETTO-JM-L33457

Cardiac Radionuclide Imaging

JM · Effective Oct 1, 2015

LCD · FIRST_COAST-L38396

Cardiology Non-emergent Outpatient Stress Testing

J9 · Effective Mar 15, 2020

LCD · NOVITAS-JH-L35083

Cardiology Non-emergent Outpatient Stress Testing

JH · Effective Oct 1, 2015

LCD · NOVITAS-JL-L35083

Cardiology Non-emergent Outpatient Stress Testing

JL · Effective Oct 1, 2015

Article · A56476

Billing and Coding: Cardiac Radionuclide Imaging

National · Effective Oct 1, 2026

Article · A56423

Billing and Coding: Cardiology Non-emergent Outpatient Stress Testing

JL · Effective Jan 1, 2026

Article · A56952

Billing and Coding: Cardiology Non-emergent Outpatient Stress Testing

J9 · Effective Jan 1, 2026

Article · A58559

Billing and Coding: Independent Diagnostic Testing Facilities (IDTF)

National · Effective Aug 6, 2026

Commercial payer policies listing 78491

15 policies from 12 payers

Summary of the payer’s published policy. Not a coverage determination — confirm with the payer before submitting.

Carelon Medical Benefits Management

Carelon Medical Benefits Management policies listing 78491, with the code’s status in each
Policy	Effective	Status of 78491
Imaging of the HeartClinical Guideline · CARELON-IMAGING-OF-THE-HEART	Sep 19, 2026	Covered
Imaging of the Heart [for Wellpoint Massachusetts]Clinical Guideline · CARELON-IMAGING-OF-THE-HEART-SUPERSEDED	Nov 15, 2025	Covered

Cigna

Cigna policies listing 78491, with the code’s status in each
Policy	Effective	Status of 78491
Cigna Commercial Radiology Code ListPayerPolicy · EVICORE-HPLAN-CIGNA-3623642AC89E	Mar 7, 2026	Prior auth required
Cigna Comprehensive Code ListPayerPolicy · EVICORE-HPLAN-CIGNA-1766449955E6

78491 coverage policies: Medicare and commercial payers

Medicare policies listing 78491

Cardiac Radionuclide Imaging

Cardiac Radionuclide Imaging

Cardiology Non-emergent Outpatient Stress Testing

Cardiology Non-emergent Outpatient Stress Testing

Cardiology Non-emergent Outpatient Stress Testing

Billing and Coding: Cardiac Radionuclide Imaging

Billing and Coding: Cardiology Non-emergent Outpatient Stress Testing

Billing and Coding: Cardiology Non-emergent Outpatient Stress Testing

Billing and Coding: Independent Diagnostic Testing Facilities (IDTF)

Commercial payer policies listing 78491

Carelon Medical Benefits Management

Cigna

78491 coverage policies: Medicare and commercial payers

Medicare policies listing 78491

Cardiac Radionuclide Imaging

Cardiac Radionuclide Imaging

Cardiology Non-emergent Outpatient Stress Testing

Cardiology Non-emergent Outpatient Stress Testing

Cardiology Non-emergent Outpatient Stress Testing

Billing and Coding: Cardiac Radionuclide Imaging

Billing and Coding: Cardiology Non-emergent Outpatient Stress Testing

Billing and Coding: Cardiology Non-emergent Outpatient Stress Testing

Billing and Coding: Independent Diagnostic Testing Facilities (IDTF)

Commercial payer policies listing 78491

Carelon Medical Benefits Management

Cigna

Cigna Medicare Advantage / HealthSpring

Aetna

BCBS Illinois

BCBS Montana

BCBS New Mexico

BCBS Oklahoma

EmblemHealth GHI

EOCCO / Moda Health

Health Partners Plans / Jefferson Health Plans

The Health Plan

Policy	Effective	Status of 78491
Cigna Commercial & Medicare Cardiology & Radiology Code ListPayerPolicy · EVICORE-HPLAN-CIGNA_MEDICARE-B17FDA871CCE	Jan 1, 2026	Prior auth required
Cigna OBM Radiology Code ListPayerPolicy · EVICORE-HPLAN-CIGNA_MEDICARE-8D36BD1DD145	Jan 1, 2026	Prior auth required