Cardiac Computed Tomography (CCT) and Coronary Computed Tomography Angiography (CCTA)

CCTA is covered for diagnostic evaluation of coronary anatomy in symptomatic patients when results are expected to influence management, including rule-out of significant CAD in low-to-intermediate pre-test probability, evaluation after equivocal stress testing, assessment of suspected graft or in-stent lesions, suspected congenital coronary anomalies, and pre-procedural venous anatomy mapping. Coverage excludes screening in asymptomatic individuals, isolated calcium scoring, use when results will not change management, cases with extensive pre-test coronary calcification that impair interpretation, and (effective 12/01/2009) requires multidetector CT scanners with >=64 slices per rotation for stenosis or functional assessment; providers and staff must meet specified credentialing, supervision, and documentation requirements.

"CCTA may be used to reliably rule out significant coronary artery disease (CAD) in patients with low to intermediate pre-test probability of CAD as an alternative to an imaging stress test."