Percutaneous Coronary Intervention

Percutaneous coronary intervention (PCI) is covered for acute coronary syndromes (including acute myocardial infarction and unstable angina), significant obstructive coronary atherosclerotic disease, restenosis after prior revascularization, chronic angina, and silent ischemia; adjunctive intracoronary imaging or flow measurements (e.g., IVUS, Doppler/CFVR) may be covered when needed. Diagnostic cardiac catheterization prior to PCI is covered and may be performed the same day, but repeat diagnostic catheterization within three months is generally not reimbursable without documented new clinical change; multiple component services (intra-procedural angiography, embolic protection devices, temporary pacemakers, drug injections, and closure devices) are considered included in the PCI and are not separately billable.

"Percutaneous coronary intervention (PCI) is covered for patients with acute coronary syndromes, including acute myocardial infarction and unstable angina."