CommercialCoverageMedium impact
Policy Criteria Change
Arkansas Blue Cross Blue Shield·AR · Cardiology, Radiology·Medical Policy
Effective date
Sep 19, 2026
We identified it
Jun 19, 2026
Summary
Arkansas Blue Cross updated coverage criteria for cardiac CT procedures effective September 19, 2026. Key changes include requiring a 5-year gap between CT coronary calcium scoring tests and designating AI-based coronary plaque analysis and automated calcium scoring as non-covered services.
Action Required
By September 19, 2026: Billing team must update pre-authorization processes to verify CT coronary calcium scoring has not been performed within preceding 5 years before scheduling. Update billing software to flag AI-based quantitative coronary tomography (AI-QCT), coronary plaque analysis (AI-CPA), and AI-based automated coronary calcium detection as non-covered services. Train staff to deny or redirect these non-covered AI services to prevent claim denials.