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Billing and Coding: Non-Invasive Fractional Flow Reserve (FFR) for Ischemic Heart Disease
A58095
Effective: January 1, 2024
Updated: December 31, 2025
Policy Summary
Non‑invasive FFRct is a post‑procedure analysis performed on imaging data from a previously obtained Coronary CT Angiography (CCTA) and is intended for patients with symptoms consistent with stable ischemic heart disease. Claims must include the referring/ordering physician name and NPI and medical record documentation of the clinical findings leading to CCTA, the CCTA report, BMI, and the FFR analysis report; billing is subject to NCCI/OPPS edits and an ABN may be required if the service is likely non‑covered.
Coverage Criteria Preview
Key requirements from the full policy
"FFRct is indicated for evaluation of ischemic heart disease when imaging data from a previously performed Coronary CT Angiography (CCTA) are submitted for FFRct analysis."
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