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Functional neuroimaging for primary degenerative dementia or mild cognitive impairment

Coverage decision: Not covered (Effective date: July 01, 2015)

Functional neuroimaging for primary degenerative dementia or mild cognitive impairment is not covered. This coverage decision involves the following functional neuroimaging technologies:Positron Emission Tomography (PET), Single Photon Emission Computed Tomography (SPECT), and Functional Magnetic Resonance Imaging (fMRI).

Note: Other emerging functional neuroimaging technologies, such as β-amyloid PET imaging, were not reviewed. The use of those technologies for primary degenerative dementia or mild cognitive impairment may be reviewed and authorized where appropriate on a case by case basis.

Background Policy Information

The State Health Technology Clinical Committee (HTCC) reviewed Functional neuroimaging for primary degenerative dementia or mild cognitive impairment on January 16, 2015. The committee’s determination, based on a systematic review of the evidence of safety, efficacy and cost-effectiveness, is that functional neuroimaging for primary degenerative dementia or mild cognitive impairment is not a covered benefit.  Complete information on this HTCC determination is available here: http://www.hca.wa.gov/about-hca/health-technology-assessment/health-technology-reviews

Billing codes

CPT code: 70554, 70555, 78607 and 78608

Regulatory authority and related information

 

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