CMS Releases Decision Memo on Cardiac CT Scans

On March 12, 2008, the Centers for Medicare & Medicaid Services (CMS) released a final decision memorandum indicating that no national coverage determination on the use of cardiac computed tomography angiography (CTA) for coronary artery disease is appropriate at this time. According to the final decision memorandum, coverage should continue to be determined by local Medicare contractors through the local coverage determination process or case-by-case adjudication.

On July 13, 2007, CMS opened a national coverage analysis for CTA.  On December 13, 2007, CMS released a proposed decision memorandum and invited public comment.  In the proposed decision memorandum, CMS proposed adding language to Section 220.1 of the National Coverage Determination Manual indicating that evidence is inadequate to conclude that CTA is reasonable and necessary for the diagnosis of coronary artery disease (CAD).  However, under certain conditions and standards, the proposed decision memorandum would have provided for coverage with evidence development for symptomatic patients with:

• chronic stable angina at intermediate risk of CAD; or
• unstable angina at low risk of short-term death and intermediate risk of CAD.