EmblemHealth will reimburse cardiologists for approved echocardiography studies (CPT codes 93303, 93304, 93306, 93307, 93308, 93350 and 93351) and nuclear studies (CPT codes 78451, 78452, 78453, 78454, 78466, 78468, 78469, 78472, 78473, 78481, 78483 and 78494), but only if they are performed at accredited locations. Prior approval rules continue to apply where applicable.
Accreditation for echocardiography studies requires both:
- Cardiology board certification of the physician by the American Board of Internal Medicine (ABIM) or American Osteopathic Board of Internal Medicine (AOBIM) and
- That services are rendered in laboratories accredited by the Intersocietal Commission for the Accreditation of Echocardiography Laboratories (ICAEL)
Accreditation for nuclear studies requires both:
- Certification of the physician by the American Board of Radiology (ABR), American Board of Nuclear Medicine (ABNM) or Certification Board of Nuclear Cardiology (CBNC) and
- That services are rendered in laboratories accredited by the Intersocietal Commission for the Accreditation of Nuclear Laboratories (ICANL) or American College of Radiology (ACR)