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Cardiac Computed Tomography (CCT)/Coronary Computed Tomographic Angiography (CCTA) - (Effective Date - 2026-10-15) 6.01.34
Effective date
Oct 15, 2026
Identified
Jul 16, 2026
Summary
Excellus BlueCross BlueShield medical policy 6.01.34 on cardiac computed tomography (CT) and coronary CT angiography (CCTA) has a current effective date of October 15, 2026. The June 18, 2026 revision added new criteria for individuals with a prior history of cardiac surgery or a history of coronary artery disease (CAD), and clarified the criteria for preoperative assessment before a planned liver or kidney transplant. CCTA is considered medically appropriate for the listed chest pain and cardiac indications, and it is considered investigational for all other indications.
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What to do
Action · 5 steps
01Already effective October 15, 2026: Billing team should code cardiac CT and CCTA claims only for indications this policy lists, and the chart should document the qualifying indication, such as chest pain with symptoms that persist after a normal stress test, a new abnormal rest ECG, chest pain with syncope, a coronary artery calcium score greater than 100, or a prior history of PCI or CABG with obstructive CAD.
02Coronary plaque quantification (CPT 75577) is medically necessary only when the individual has acute or stable chest pain with no known CAD, the current CCTA result is intermediate risk or CAD-RADS 1, 2, or 3, and the cardiac evaluation is negative or inconclusive for acute coronary syndrome.
03Coronary plaque quantification is considered not medically necessary for unstable coronary syndromes, when performed with invasive coronary catheterization, for screening or disease surveillance, within 30 days of a myocardial infarction, or when the CCTA is normal, CAD-RADS 0, shows high-grade stenosis (>70%), or is CAD-RADS 4 or 5.
04Routine surveillance cardiac CT after transcatheter aortic valve replacement (TAVR) for incidental hypoattenuated leaflet thickening (HALT) with or without restricted leaflet motion, also known as hypoattenuation affecting motion (HAM), is considered not medically necessary.
05Noninvasive FFR-CT (CPT 75580) is medically appropriate to further assess CAD seen on a recent coronary CTA that is of uncertain physiologic significance.
Codes mentioned
7557275573755747557775580
Original notice
Cardiac Computed Tomography (CCT)/Coronary Computed Tomographic Angiography (CCTA) - (Effective Date - 2026-10-15) 6.01.34
excellusbcbs.com · Always check the source before changing claims.
Related changes
See all Excellus BlueCross BlueShield changes →Computed Tomography (CT) for Coronary Calcium Scoring 6.01.13MediumEffective May 15, 2026 · Radiology (x-rays) & ImagingCardiac Computed Tomography (CCT)/Coronary Computed Tomographic Angiography (CCTA) 6.01.34HighEffective May 15, 2026 · Radiology (x-rays) & ImagingCardiac Computed Tomography (CCT)/Coronary Computed Tomographic Angiography (CCTA) 6.01.34MediumEffective May 15, 2026 · Radiology (x-rays) & ImagingBrowse every Excellus BlueCross BlueShield change in the policy list