Coronary CTA: Can it survive?

March 4, 2008 Diagnostic Imaging. Coronary CTA: Can it survive? CMS stirs up hornet’s nest with threat to disallowan option for local Medicare coverage decisions and prohibit cardiac CT angiography for all but trial patients Greg Freiherr ------------------------------------------------------------------------------ In a week or two, the Centers for Medicare and Medicaid Services will weigh in with its decision on whether to overturn local Medicare coverage of cardiac CT angiography for the diagnosis of coronary artery disease. Its proposal, made last December, to change the current approach would make an exception only if patients were enrolled in research trials preapproved by Medicare. It sent a collective shudder down the spine of medical practitioners in the U.S. Physicians across the U.S. are now being reimbursed by Medicare for coronary CTA thanks to determinations made individually by local third-party payers. This CMS policy, which allows insurance companies contracted with Medicare to cover procedures as they see fit, has bridged the reimbursement gap that typically exists between the introduction of a new technology and CMS’ issuance of a national coverage policy. These local coverage decisions have helped cardiac CTA to spread, which has fostered enough positive research to convince several medical societies to embrace it. This in itself is worth noting, as the groups that have agreed on coronary CTA don’t agree on much.

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