Cardiac Computed Tomography & Angiography (CCTA)

CCTA is covered when used to evaluate symptomatic suspected CAD with intermediate pre-test probability (10%–90%) and appropriate EKG/lab findings or when assessing structural/morphologic cardiac anomalies (masses, pericardial disease, pulmonary vein anatomy prior to ablation, coronary mapping prior to device placement or repeat surgery, congenital anomalies, or new-onset heart failure). Coverage is limited to modern multidetector CT scanners meeting specific technical parameters (≤0.625 mm collimation and ≤375 ms rotation or ≥64 slices), excludes screening asymptomatic patients, EBT/EBCT, and triple rule-out ED protocols, and requires documentation of indication, pre-test probability, relevant prior tests, scanner specs, and assessment of coronary calcification impact.

"CCTA is covered for evaluation of acute chest pain, unexplained dyspnea, or symptoms suggesting angina when the patient has intermediate pre-test probability of CAD (10%–90%), no EKG changes sugges..."