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Calculation of fractional flow reserve (HeartFlow FFR CT) for persons who have a coronary CTA that has shown coronary artery disease of uncertain functional significance, or is non-diagnostic.Īetna considers CT angiography of cardiac morphology for pulmonary vein mapping medically necessary for the following indications:.Detection and delineation of suspected coronary anomalies in young persons (less than 30 years of age) with suggestive symptoms (e.g., angina, syncope, arrhythmia, and exertional dyspnea without other known etiology of these symptoms in children and adults dyspnea, tachypnea, wheezing, periods of pallor, irritability (episodic crying), diaphoresis, poor feeding and failure to thrive in infants).Pre-operative assessment for planned non-coronary cardiac surgeries including valvular heart disease, congenital heart disease, and pericardial disease, in lieu of cardiac catheterilzation as the initial imaging study, in persons with low or intermediate pretest risk of obstructive CAD.The ACC defines high-risk surgery as emergent operations, especially in the elderly, aortic and other major vascular surgeries, peripheral vascular surgeries, and anticipated prolonged surgical procedures with large fluid shifts and/or blood loss involving the abdomen and thorax. Pre-operative assessment of persons scheduled to undergo 'high-risk" non-cardiac surgery, where an imaging stress test or invasive coronary angiography is being deferred unless absolutely necessary.Note: Current guidelines from the American Heart Association recommend against routine stress testing for screening asymptomatic adults. Evaluation of asymptomatic persons at an intermediate pre-test probability of coronary heart disease or atherosclerotic cardiovascular disease by Framingham risk scoring or Pooled Cohort Equations (see Appendix) who have an equivocal or uninterpretable exercise or pharmacological stress test or have resting electrocardiogram (ECG) changes (such as left bundle branch block (LBBB), pathologic q-waves, or right bundle branch block (RBBB) with left anterior fascicular block (LAFB) in which coronary artery disease (CAD) is a possible etiology.Rule out obstructive coronary stenosis in persons with a low or intermediate pre-test probability of coronary artery disease or atherosclerotic cardiovascular disease by Framingham risk scoring, Pooled Cohort Equations, or by American College of Cardiology (ACC) criteria (see Appendix) with a positive (i.e., greater than or equal to 1 mm ST segment depression) stress test.
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Rule out obstructive coronary stenosis in symptomatic persons with a low or intermediate pre-test probability of coronary artery disease or atherosclerotic cardiovascular disease by Framingham risk scoring, Pooled Cohort Equations, or by American College of Cardiology (ACC) criteria (see Appendix),.Aetna considers cardiac computed tomography (CT) angiography of the coronary arteries using 64-slice or greater medically necessary for the following indications: