Indications and reimbursement of cardiac computed tomography angiography: history, present and future perspectives

To comment that cardiac computed tomography angiography (CCTA) is an exciting tool in the evaluation of coronary artery disease (CAD) is an understatement. As a new method, however, differing clinical and reimbursement guidelines exist to guide the use of the method, resulting in confusion among referring and interpreting physicians in whether CCTA is reasonably indicated and covered by an individual patient's payer. Such confusion has slowed the acceptance of CCTA within the medical community. Clinical and reimbursement guidelines related to CCTA indications, including those from public and private payers, are reviewed, summarized, and compared in text and table formats. The commonalities extant within medical society guidelines and gradually within the payer community allow the increasingly frequent use of CCTA for certain indications. Challenges to full-fledged acceptance of the technique based on guideline and payer policies are reviewed and are increasingly being overcome.