ASNC Responds to CCTA Decision
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January 24, 2008
On January 11, 2008, ASNC and five other specialty societies submitted comments to the Centers for Medicare and Medicaid Services (CMS) in response to the proposed national coverage decision for coronary computed tomography angiography (CCTA), which CMS released on December 13, 2007. In the decision memo, CMS proposed coverage with evidence development for diagnosis of coronary artery disease (CAD) for 1) symptomatic patients with chronic stable angina at intermediate risk of CAD; or 2) symptomatic patients with unstable angina at a low risk of short-term death and intermediate risk of CAD. All other uses of CCTA for the diagnosis of CAD would be non-covered. CCTA for uses other than the diagnosis of CAD would remain at contractor discretion.
In the response letter sent to CMS, ASNC joined the ACC, ACR, NASCI, SCAI and SCCT in strongly urging CMS to continue to allow local Medicare carriers to determine coverage through the Local Coverage Determination (LCD) process. Among the many reasons not to move forward with an NCD, the societies listed the lack of available relevant evidence included in the proposed decision memo’s findings and provisions; the exclusion of clinically valuable indications for CCTA that are well supported by existing evidence; inaccurate definitions of patient populations for the proposed coverage with evidence development; inappropriately defined questions, unlikely to yield beneficial information that were outlined by CMS for clinical studies to qualify for CED; and the hindering effects an NCD would have on the development of evidence by academia, societies and registries related to the utility of CCTA.
Following a review of all submitted comment, CMS is expected to release a final coverage decision memo on CCTA in March 2008.
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