Non-Invasive Fractional Flow Reserve (FFR) for Ischemic Heart Disease

Noninvasive FFR (FFRct) is covered for intermediate-risk patients (per 2021 chest pain guidelines) with acute or stable chest pain when CCTA demonstrates 40–90% stenosis in proximal or mid coronary arteries, and as an alternative to stress testing when CCTA image quality is adequate. It is also covered for stable nonobstructive CAD patients with persistent ischemia-related symptoms despite maximally tolerated medical therapy. FFRct is excluded for many clinical scenarios (recent MI ≤30 days, suspected ACS not ruled out, intracoronary stents, prior CABG grafts or prosthetic valves, post-transplant, new systolic HF without prior cath, high-grade >90% or low-grade <40% stenoses, or when turnaround times would impair timely care).

"FFRct is covered for patients classified as intermediate risk (per 2021 AHA/ACC/ASE/CHEST/SAEM/SCCT/SCMR chest pain guideline) with acute or stable chest pain, no prior known coronary artery stenos..."