Artificial Intelligence Enabled CT Based Quantitative Coronary Topography (AI-QCT )/Coronary Plaque Analysis (AI-CPA)
L39881
AI-QCT/AI-CPA using CCTA is covered when performed after a completed/interpreted CCTA in symptomatic patients (acute or stable chest pain) without known CAD who are classified as intermediate risk or CAD-RADS 1–3 and whose cardiac evaluation is negative or inconclusive for ACS. Coverage requires FDA-cleared software and appropriately trained/credentialed providers; the service is not covered for screening, in asymptomatic patients, with contraindication to CCTA, when CCTA is normal (CAD-RADS 0), when high-grade stenosis (CAD-RADS 4–5 or >70%) is present, within 30 days post-MI, for unstable symptoms, in conjunction with invasive catheterization, or for routine surveillance.
"Patient with acute or stable chest pain, no known coronary artery disease (no prior anatomic testing showing plaque or obstructive CAD), and eligible for coronary CT angiography (CCTA)."
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