Blue Cross & Blue Shield of MississippiAll Plans · Coverage · Medical Policy · Neurology, Nuclear Medicine, RadiologyHigh impact
Selected Positron Emission Tomography Technologies for Evaluation of Alzheimer Disease
Effective date
Not stated in the notice
Identified
Jul 2, 2026
Summary
Amyloid beta imaging with PET is now medically necessary to select individuals with mild cognitive impairment or mild dementia due to Alzheimer disease for amyloid beta targeting plaque-therapy, where it was previously investigational. CPT 78811 and 78814 and HCPCS A9586, Q9982 and Q9983 changed from investigational to medically necessary, ICD-10 codes G30.0-G30.9 were added, and HCPCS A4641 and A9598 were removed from the policy. Tau imaging with PET is investigational for predicting conversion to Alzheimer disease, as an adjunct to clinical diagnosis in individuals with dementia, and for selecting individuals for amyloid beta targeting plaque-therapy, and all other uses of amyloid beta imaging with PET remain investigational.
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01Billing team: Bill CPT 78811 and 78814 and HCPCS A9586, Q9982 and Q9983 as medically necessary only for amyloid beta imaging with PET to select individuals with mild cognitive impairment or mild dementia due to Alzheimer disease for amyloid beta targeting plaque-therapy, and report the ICD-10 codes G30.0-G30.9 for Alzheimer disease.
02Document medical necessity for each study, because no payment is made for services not documented to be medically necessary, and a provider's order does not by itself make a service medically necessary.
03The policy lists all other amyloid beta PET uses and all tau imaging with PET as investigational.
04HCPCS A4641 and A9598 were removed from the policy.
Codes mentioned
7881178814A9586Q9982Q9983A4641A9598G30.0G30.9
Original notice
Selected Positron Emission Tomography Technologies for Evaluation of Alzheimer Disease
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