405 Ind. Admin. Code 5-27-7

Current through December 4, 2024

Section 405 IAC 5-27-7 - Positron emission tomography

Authority: IC 12-15-1-10; IC 12-15-1-15; IC 12-15-21-2; IC 12-15-21-3

Affected: IC 12-13-7-3; IC 12-15

Sec. 7.

(a) As used in this section, "positron emission tomography" or "PET" scan means any diagnostic test that utilizes a radioactive substance to look for disease in the body or staging of a disease. This also includes any combined radiologic exam, such as a computerized tomography (PET-CT) exam or magnetic resonance (PET-MR) exam.

(b) Prior authorization shall be required for all PET scans.

(c) Medicaid reimbursement may be available for PET scans performed for medically necessary conditions as determined by the office.

405 IAC 5-27-7

Office of the Secretary of Family and Social Services; 405 IAC 5-27-7; filed 9/11/2019, 9:52 a.m.: 20191009-IR-405180375FRA

Readopted filed 11/13/2019, 11:54 a.m.: 20191211-IR-405190487RFA

Readopted filed 5/30/2023, 11:54 a.m.: 20230628-IR-405230292RFA