Cardiac Biomarkers for Myocardial Infarction
This document governs Blue Cross Blue Shield of New Mexico's reimbursement criteria for laboratory cardiac biomarkers used in the diagnosis and prognosis of myocardial infarction and applies to providers submitting claims under BCBSNM plans.
No material clinical or coverage changes in this revision.
Reimbursement Criteria
BCBSNM cardiac biomarker reimbursement criteria
Reimbursement stance for specific cardiac biomarkers when used to evaluate patients presenting with signs and symptoms of acute coronary syndrome (ACS).
ALL of the following
ALL of the following
- Patient presents with signs and symptoms of acute coronary syndrome (see policy definitions).
ALL of the following
- Measurement of cardiac troponin (troponin T or I) for the diagnosis of myocardial infarction (MI) may be reimbursable in patients presenting with signs and symptoms of ACS.
ALL of the following
The following biomarkers are NOT reimbursable for diagnosis and/or prognosis of MI in patients with signs/symptoms of ACS:
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