CMS opens national coverage analysis of CT

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The Centers for Medicare and Medicaid Services (CMS) opened a national coverage analysis (NCA) to evaluate the available evidence for use of cardiac computed tomography angiography (CTA) to diagnose coronary artery disease.

According to the NCA tracking sheet, CTA, which includes helical (spiral) CT and multi-slice CT angiography, has two potential uses: as a substitute for invasive coronary angiography; and evaluation of chest pain in the emergency room.

“Proponents have claimed that the use of cardiac CTA will lead to better health outcomes and a reduction in cardiac catheterization, the current standard for diagnosis of coronary artery disease,” CMS says. “CMS is concerned that despite the lack of clinical evidence to demonstrate improved patient health outcomes with CTA, the procedure has been rapidly adopted by the clinical community.”

The NCA will evaluate the available evidence for CTA when used to diagnose coronary artery disease and determine if a national coverage determination is warranted. CMS also will consider the potential of Coverage with Evidence Development as an appropriate NCD decision.

CMS is soliciting public comments on the NCA through July 13. The American College of Cardiologists’ regulatory staff and the CT workgroup of the Cardiovascular Imaging Collaborative are in the process of developing comments.