Artificial Intelligence Enabled CT Based Quantitative Coronary Topography (AI-QCT)/Coronary Plaque Analysis (AI-CPA)

AI-QCT/AI-CPA using CCTA is covered for patients with acute or stable chest pain, no known CAD, who are eligible for CCTA, when CCTA shows intermediate risk or CAD-RADS 1–3 and the cardiac evaluation is negative or inconclusive for ACS. The AI analysis must be performed after a completed and interpreted CCTA using FDA-cleared/approved software and by appropriately credentialed providers; coverage is excluded for screening, contraindications to CCTA, normal CCTA (CAD-RADS 0), high-grade stenosis (CAD-RADS 4–5 or >70%), within 30 days post-MI, unstable symptoms, concurrent invasive catheterization, or for routine surveillance.

"AI-QCT/AI-CPA using CCTA is covered when the patient has acute or stable chest pain, no known coronary artery disease, and is eligible for CCTA."

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