Billing and Coding: Artificial Intelligence Enabled CT Based Quantitative Coronary Topography (AI-QCT)/Coronary Plaque Analysis (AI-CPA)

AI-QCT/AI-CPA is payable only when performed as a post-processing analysis of a medically indicated CCTA that meets LCD L33947 requirements, and only after the CCTA has been completed and interpreted. Claims must include a valid ICD-10-CM diagnosis code, the ordering/referring physician name and NPI, and documentation (history/physical, symptoms, CCTA report, and AI analysis report); non-covered services require appropriate ABN/modifier use and may be automatically denied by MACs.

"AI-QCT/AI-CPA is covered only for patients who have a medically indicated CCTA and meet all requirements of LCD L33947 for Cardiac CT (CCT) and Coronary CT Angiography (CCTA)."

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