Carelon has received several questions regarding upcoming codes for LiverMultiScan (LMS) – CPT 0648T/0649T and Cone-beam breast CT (CBCT) – CPT 0633T-0638T. Additional information and rationale is provided below to clarify how these codes will be managed.

For LiverMultiScan, evidence to date is limited regarding patient-centered outcomes, however, LMS demonstrates comparable diagnostic accuracy to existing modalities (such as liver biopsy, MR elastography, quantitative multiparametric MRI, and vibration-controlled transient elastography), with a shorter overall acquisition time and without the need for additional elastography equipment. As current Carelon guidelines include indications for both MR elastography and multiparametric MRI, it was determined that LMS was appropriate as an alternative when criteria for those modalities were met. Please refer to the Rationale section in our Abdomen/Pelvis Imaging guideline for more information and references.

Cone-beam breast CT is in scope for the Carelon Radiology program, but evidence to date is insufficient to support its routine use. As such, there are no guideline indications for CBCT. Indications, diagnoses, or imaging modalities not specifically addressed in our guideline are considered not medically necessary. Please refer to the Rationale section in our Oncologic Imaging Guideline for more information and references.