78434 CPT® code: payer coverage and prior authorization10 of 10 payer prior-auth lists that name 78434 require prior authorization or set conditions: Aetna, Blue Cross Blue Shield of Arizona (AZ Blue), Blue Shield of California Promise Health Plan, Cigna, HealthSpring, Rocky Mountain Health Plans.
| Payer | Plan | State | Prior auth | Conditions | Since | Source |
|---|---|---|---|---|---|---|
| Blue Cross Blue Shield of Arizona (AZ Blue) | Federal Employee Program (FEP) | AZ | prior auth under conditions | FEP Blue Focus only | Sep 1, 2026 | Federal Employee Program (FEP) Prior Authorization Requirements Code List (Updated 09/01/2026) |
| Blue Shield of California Promise Health Plan | Promise Health Plan Medi-Cal | CA | prior auth required | Sep 1, 2026 | Medi-Cal Prior Authorization List | |
| Aetna | Commercial | All | prior auth required | Not required for Student Health or Allina Health | Aetna plans | Oct 1, 2026 | Participating provider precertification list for Aetna® |
| Aetna | Medicare Advantage | All | prior auth required | Not required for Student Health or Allina Health | Aetna plans | Oct 1, 2026 | Participating provider precertification list for Aetna® |
| Cigna | ACA/IFP | All | prior auth required | May be delegated to eviCore for some clients | Jan 1, 2020 | Master Precertification List (For Health Care Providers) |
| Cigna | Complete/PHS+/Preferred | All | prior auth required | May be delegated to eviCore for some clients | Jan 1, 2020 | Master Precertification List (For Health Care Providers) |
| Cigna | Radiology | All | prior auth under conditions | Add-on code: requested with the primary procedure | Mar 7, 2026 | Cigna Commercial Comprehensive CPT Code Reference for Prior Authorization Across All Programs |
| Cigna | Radiology | All | prior auth under conditions | Add-on code: requested with the primary procedure | Mar 7, 2026 | Cigna Commercial Prior Authorization Procedure Code List: Radiology |
| HealthSpring | Medicare Advantage | All | prior auth required | Jan 1, 2025 | 2026 Q4 Prior Authorization List | |
| Rocky Mountain Health Plans | Rocky Mountain Medicare Advantage D-SNP | CO | prior auth required | Feb 1, 2025 | Rocky Mountain Health Plans Medicare Advantage Dual-Special Needs Plans – prior authorization Effective February 1, 2025 |
78434 appears in 6 coverage policies from Aetna, Blue Cross & Blue Shield of Mississippi, Blue Shield of California, BlueCross BlueShield of South Carolina, UnitedHealthcare.
| Payer | Policy | Role in policy | Reviewed | Document |
|---|---|---|---|---|
| Aetna | Magnetic Resonance Imaging of the Cardiovascular System - Cardiac MRI (0520) | listed, no stance (range 78414-78499) | Aug 20, 2026 | payer document |
| Aetna | Positron Emission Tomography (PET) (0071) | covered if criteria are met | Sep 14, 2026 | payer document |
| Blue Cross & Blue Shield of Mississippi | Cardiac Applications Of Pet Scanning | not covered | payer document | |
| Blue Shield of California | Cardiac Applications of Positron Emission Tomography Scanning (6.01.20) | listed, no stance | payer document | |
| BlueCross BlueShield of South Carolina | Heart (Cardiac) PET With CT for Attenuation (CAM 763) | listed, no stance | Dec 1, 2024 | payer document |
| UnitedHealthcare | Positron Emission Tomography Scan for Myocardial Imaging (MMP242.20) Positron Emission Tomography Perfusion of the Heart | listed, no stance | Sep 1, 2026 | payer document |
Prior authorization required or conditional in CO, FL, IN, KY, MS, WA.
From payers' published prior-auth lists, coverage policies and state Medicaid fee schedules, updated Oct 16, 2026. The role is what the policy's own code table or text says about the code. Not a guarantee of coverage or payment; verify with the payer. CPT® is a registered trademark of the American Medical Association.