The Society of Cardiovascular Computed Tomography (SCCT) applauded final local coverage determinations (LCDs) for AI-coronary plaque analysis (AI-CPA) released by four of the seven Medicare administrative contractors (MACs).
The four contractors for the U.S. Centers for Medicare and Medicaid Services (CMS) – including CGS, National Government Services (NGS), Palmetto GBA, and Wisconsin Physicians Service Insurance Corporation (WPS) – provided updated LCDs for current procedural terminology (CPT) codes 0623T - 0626T.
AI-CPA using coronary CT angiography (CCTA) is considered reasonable and medically necessary as a diagnostic study when the patient is eligible for CCTA, according to the new LCDs. This includes patients presenting with acute or stable chest pain, being at intermediate risk for coronary artery disease (CAD) or having evidence of CAD-RADS level 1, 2, or 3 disease on their CCTA, and being negative or inconclusive for acute coronary syndrome (ACS).
The LCDs have a future effective date of November 24, 2024.
SCCT leaders said this is a positive step toward improved patient care, with increased access to AI-CPA having the potential to reduce unnecessary invasive procedures. Society members in 2023 presented as subject matter experts during a MAC-led multijurisdictional meeting and later provided comments on the draft LCDs that helped shape the final policies.
The SCCT's full statement can be found here.
