[Medical Director]
[Name of Contractor]
[Address]
[Address]
[Date], 2014
RE: Concerns regarding AdreView (Iobenguane I 123 Injection)
Dear Dr. [Medical Director],
I write to express the American Society of Nuclear Cardiology’s great concern regarding payment for AdreView (Iobenguane I 123 Injection). ASNC is a 4, 500 member professional not-for-profit organization, international in scope, which provides its members with a variety of continuing medical education programs related to nuclear cardiology and cardiovascular computed tomography (CT), promotes accreditation and certification in nuclear cardiology and is the principal advocacy voice for the profession. Ensuring that third-party payers implement appropriate coverage policies related to the services our members provide to patients is of the utmost importance and we appreciate your consideration of our concern.
As you may know, AdreView (Iobenguane I 123 Injection) is a radiopharmaceutical agent for gamma-scintigraphy with a cardiac indication for scintigraphic assessment of sympathetic innervation of the myocardium by measurement of the heart-to-mediastinum (H/M) ratio of radioactivity uptake in patients with New York Heart Association (NYHA) Class II or Class III heart failure and left ventricular ejection fraction (LVEF) ≤ 35%. Among these patients,
AdreView may be used to help identify patients with lower one-and two-year mortality risks, as indicated by and H/M ratio ≥ 1.6.
ASNC convened a multi-society writing committee and is currently in the process of producing a model coverage policy that will delineate indications where AdreView should receive coverage.
In the interim, ASNC strongly objects to any policy that denies payment for AdreView in all cases. Payers should make case-by-case assessments based on medical necessity and should not deny coverage across the board.
Furthermore, AdreView, as a Category III code (CPT 0331T or 0332T), is being tracked to monitor when and for what indications it is used. This will allow clinicians and payers to understand populations and instances in which AdreView is most advantageous in the future.
However, if payers refuse to examine each claim on an individual basis, they will stifle clinical progress.

Thank you for your consideration of our concerns. If you require further information or have any questions please feel free to contact Georgia Hearn, Senior Specialist, Regulatory Affairs at 301-215-
7575 ext. 207 or at ghearn@asnc.org
.
Sincerely
Gordon E. Depuey, MD
President, American Society of Nuclear Cardiology