All PlansCoverageMedium impact
Radioimmunoscintigraphy (Monoclonal Antibody Imaging) With Indium 111 Capromab Pendetide for Prostate Cancer
Blue Cross & Blue Shield of Mississippi·MS · Urology, Oncology, Nuclear Medicine +1 more·Medical Policy
We identified it
Jun 20, 2026
Summary
This policy designates radioimmunoscintigraphy using indium 111 capromab pendetide (ProstaScint) as investigational for prostate cancer evaluation, meaning it is not considered medically necessary and claims will likely be denied. The policy has been reviewed but unchanged since 2017.
Action Required
Immediately: Billing team must flag CPT codes 78800-78804 and HCPCS A9507 for indium 111 capromab pendetide procedures as investigational in billing system. Notify providers that these procedures for prostate cancer imaging are considered investigational and claims will likely be denied. Update authorization workflows to warn staff about non-coverage.