RAD.00057 Near-Infrared Coronary Imaging and Near-Infrared Intravascular Ultrasound Coronary Imaging

This policy addresses near-infrared coronary imaging (spectroscopy) and near-infrared intravascular ultrasound (NIR-IVUS) used to assess coronary plaque (e.g., LipiScan, InfraReDx/TVC systems). Anthem considers these services investigational and not medically necessary for all indications; therefore, they are not covered under any circumstances (including when reported with CPT/HCPCS 93799).

"Near-infrared coronary imaging is consideredinvestigational and not medically necessaryfor all indications."

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