NCDActive
Displacement Cardiography
NCD262
Effective: October 12, 1988
Updated: December 31, 2025
Policy Summary
Cardiokymography is covered (for services on/after 1988-10-12) only when performed as an adjunct to electrocardiographic stress testing to evaluate coronary artery disease — specifically for males with atypical angina or nonischemic chest pain and for females with typical or atypical angina. Photokymography is explicitly excluded from coverage. Cardiokymography performed for other indications or not as an adjunct to ECG stress testing is not covered.
Coverage Criteria Preview
Key requirements from the full policy
"Cardiokymography performed on or after 1988-10-12 is covered when used as an adjunct to electrocardiographic stress testing to evaluate coronary artery disease in male patients with atypical angina..."
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