Journal of Cardiovascular Computed Tomography
Volume 2, Issue 1 , Pages 3-11, January 2008

Indications and reimbursement of cardiac computed tomography angiography: History, present and future perspectives

  • Michael Shen, MD, MS, FACC, FASNC

      Affiliations

    • Section of Cardiac Imaging, Cardiovascular Medicine, Cleveland Clinic Florida, 2950 Cleveland Clinic Boulevard, Weston, FL 33331 USA
    • Corresponding Author InformationCorresponding author.
  • ,
  • Neil Saxena, MD

      Affiliations

    • Section of Cardiac Imaging, Cardiovascular Medicine, Cleveland Clinic Florida, 2950 Cleveland Clinic Boulevard, Weston, FL 33331 USA
  • ,
  • Gregory S. Thomas, MD, MPH, FACC, FACP, FASNC

      Affiliations

    • Mission Internal Medicine Group, Mission Viejo, CA, USA
    • University of California, Irvine, CA, USA

Received 8 June 2007; received in revised form 20 October 2007; accepted 8 November 2007. published online 19 November 2007.

Abstract

To comment that cardiac computed tomography angiography (CCTA) is an exciting tool in the evaluation of coronary artery disease (CAD) is an understatement. As a new method, however, differing clinical and reimbursement guidelines exist to guide the use of the method, resulting in confusion among referring and interpreting physicians in whether CCTA is reasonably indicated and covered by an individual patient’s payer. Such confusion has slowed the acceptance of CCTA within the medical community. Clinical and reimbursement guidelines related to CCTA indications, including those from public and private payers, are reviewed, summarized, and compared in text and table formats. The commonalities extant within medical society guidelines and gradually within the payer community allow the increasingly frequent use of CCTA for certain indications. Challenges to full-fledged acceptance of the technique based on guideline and payer policies are reviewed and are increasingly being overcome.

Keywords: Cardiac computed tomography, Coronary, Indications, Reimbursement

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 Conflict of interest: Dr. Thomas serves on the steering committee of a General Electric trial related to cardiac CT. Dr. Shen serves on the speaker’s bureau with speaking honorariums for TeraRecon, is a medical advisor for MedSolutions, and receives grant support from Berlex. Dr. Shen and Dr. Thomas were on the CTA Work Group of the ACC Coding and Nomenclature Committee. Dr Saxena reports no conflicts of interest.

PII: S1934-5925(07)00343-7

doi:10.1016/j.jcct.2007.11.004

Journal of Cardiovascular Computed Tomography
Volume 2, Issue 1 , Pages 3-11, January 2008