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CommercialCoverageMedium impact

Optical Coherence Tomography for Imaging of Coronary Arteries

Blue Cross & Blue Shield of Mississippi·Cardiology, Cardiothoracic Surgery·Medical Policy
Effective date
Aug 1, 2025
We identified it
Jun 20, 2026
Days to comply

Summary

Blue Cross Blue Shield policy L.2.02.410 classifies Optical Coherence Tomography (OCT) for coronary artery imaging as investigational in all situations, including as an adjunct to stent procedures and plaque risk stratification. Claims using CPT codes 92978 and 92979 for OCT procedures will likely be denied as not medically necessary.

Action Required

Action needed
By August 1, 2025: Billing team must flag CPT codes 92978 and 92979 as investigational/non-covered for BCBS plans when used for OCT procedures. Update billing system to require additional documentation justifying medical necessity or consider alternative imaging codes. Inform cardiology providers that OCT claims may be denied and to document compelling clinical circumstances if procedure is performed.

Affected Billing Codes

92978
92979