CommercialCoverageMedium impact
Miscellaneous (Noncardiac, Nononcologic) Applications of Fluorine 18 Fluorodeoxyglucose Positron Emission Tomography
Blue Cross & Blue Shield of Mississippi·MS · Nuclear Medicine, Neurology, Infectious Disease +2 more·Medical Policy
We identified it
Jun 20, 2026
Summary
Blue Cross Blue Shield of Mississippi updated their FDG-PET scan policy, specifying that these scans are only medically necessary for epileptic seizure candidates for surgery and chronic osteomyelitis diagnosis. All other uses including neurological, pulmonary, and musculoskeletal conditions are considered investigational and not covered.
Action Required
Immediately: Billing team must review all pending and future FDG-PET scan claims to ensure they are only for epileptic seizure surgical candidates or chronic osteomyelitis diagnosis. Update prior authorization protocols to verify medical necessity criteria. All other FDG-PET indications will be denied as investigational.