Cardiac Computed Tomographic Angiography (CCTA) in Coronary Artery Disease

Project History

 In 2007, the CMTP Advisory Group developed a protocol for a randomized controlled trial (RCT) comparing clinical outcomes for patients at intermediate risk for CAD initially evaluated with CCTA (64-slice and higher) against outcomes for patients receiving other diagnostic tests. The study endpoints included occurrence of major adverse cardiac events within 24 months, rates of coronary angiography, revascularization, ED visits, hospitalization, number and cost of added imaging tests, and radiation dose.  The decision by the federal Centers for Medicare and Medicaid Services (CMS) in March 2008 not to mandate coverage with evidence development (CED) as a condition for reimbursement rendered the conduct of an RCT unfeasible.  Thus, CCTA is under reconsideration as a CMTP Applied Policy Project.