Which payers have updated policy for HCPCS A9526?

Payers that have issued tracked updates for HCPCS A9526 include: Excellus BlueCross BlueShield, Blue Cross & Blue Shield of Mississippi, Aetna.

How do I get notified when HCPCS A9526 policy changes?

Create a free account at PolicyChanges.app and save a search filtered to HCPCS A9526. You will get an email when new policy changes reference this code: daily or weekly, your choice, on every plan.

Why do payers change policies for HCPCS A9526?

Payers revise policies for individual billing codes to align with updated clinical guidelines, CMS rule changes, fraud and abuse prevention measures, or network cost-management goals. Changes can affect medical necessity criteria, place-of-service restrictions, bundling rules, or whether a code requires prior authorization.

PAYER POLICY CHANGES

A9526 Insurance Policy Changes

Q: What insurance policy changes affect HCPCS A9526?

There are 3 tracked policy changes affecting HCPCS A9526, including updates from Excellus BlueCross BlueShield, Blue Cross & Blue Shield of Mississippi, Aetna. Each change may modify coverage criteria, reimbursement rates, or prior-authorization requirements.

HCPCS A9526 is officially defined as "Nitrogen n-13 ammonia, diagnostic, per study dose, up to 40 millicuries." HCPCS A9526 is referenced in 3 tracked payer policy changes from Excellus BlueCross BlueShield, Blue Cross & Blue Shield of Mississippi, and 1 other payer. For billers and coders, staying current on payer-specific coverage criteria, reimbursement rules, and prior-authorization requirements for HCPCS A9526 is critical to clean claim submission. Each entry below links to the full policy analysis with effective dates and action steps.

Excellus BlueCross BlueShield · Effective Oct 15, 2026Medium impact
Positron Emission Tomography (PET) - Non-Oncologic Applications - (Effective Date - 2026-10-15) 6.01.07
Effective October 15, 2026, absolute quantification of myocardial blood flow (AQMBF) is medically appropriate to further evaluate cardiac function when included with cardiac PET perfusion. Stress imaging with AQMBF is medically appropriate for persistent chest pain, exertional dyspnea or exertional fatigue in the setting of suspected or known non-obstructive coronary disease (MINOCA, INOCA or ANOCA), after a normal or equivocal exercise treadmill test or a diagnosis of no obstructive CAD on CCTA or invasive coronary angiography. Criteria for AQMBF with PET and stress testing with imaging, including PET MPI, were added in the June 18, 2026 review.
Blue Cross & Blue Shield of Mississippi · Identified Jun 20, 2026Medium impact
Cardiac Applications of PET Scanning
Cardiac PET scanning may be considered medically necessary for myocardial perfusion studies to diagnose coronary artery disease in individuals with an indeterminate SPECT scan, or when SPECT could reasonably be expected to be suboptimal because of body habitus or conditions such as known pericardial or pleural effusion. It may also be considered medically necessary to assess myocardial viability in individuals with severe left ventricular dysfunction being considered for revascularization, and to diagnose cardiac sarcoidosis in individuals who are unable to undergo MRI. Quantification of myocardial blood flow for cardiac event risk stratification is investigational. The policy was updated on 04/09/2026 to revise the coronary artery disease description, and its policy statements were unchanged.
Aetna · Identified Nov 1, 2026Low impact
Positron Emission Tomography (PET) (CPB 0071, reviewed 2026-10-26)
Aetna's Clinical Policy Bulletin 0071 addresses positron emission tomography (PET) and lists the PET uses Aetna considers medically necessary, including cardiac perfusion and viability imaging, amyloid and tau PET for certain dementia cases, and FDG PET for selected infectious and other conditions. The same bulletin lists many PET uses it considers experimental, investigational or unproven. The title shows the bulletin was reviewed 2026-10-26, but the source text does not describe what changed and states no effective date.

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Positron Emission Tomography (PET) - Non-Oncologic Applications - (Effective Date - 2026-10-15) 6.01.07

Cardiac Applications of PET Scanning

Positron Emission Tomography (PET) (CPB 0071, reviewed 2026-10-26)

What insurance policy changes affect HCPCS A9526?

Which payers have updated policy for HCPCS A9526?

How do I get notified when HCPCS A9526 policy changes?

Why do payers change policies for HCPCS A9526?