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

AI-QCT/AI-CPA is allowed only as post‑procedure analysis when a medically indicated CCTA meeting all CCT/CCTA requirements has been completed and interpreted (studies ordered before CCTA results or for patients not meeting the LCD are non‑covered). Claims must include the referring/ordering physician name and NPI, a valid ICD‑10 diagnosis (or test result/symptom if diagnostic), and comply with NCCI/OPPS edits, with appropriate ABN modifiers (GA/GX/etc.) used when non‑coverage is likely.