Publication Number

100-3

Manual Section Number

20.27

Version Number

1

Effective Date of this Version

This is a longstanding national coverage determination. The effective date of this version has not been posted.

Benefit Category

Diagnostic Tests (other)

Note: This may not be an exhaustive list of all applicable Medicare benefit categories for this item or service.

Item/Service Description

A cardiointegram device consists of a microcomputer which receives output from a standard electrocardiogram (EKG) and transforms it to produce a graphic representation of heart electrophysiologic signals. This procedure is used primarily as a substitute for Exercise Tolerance Testing with Thallium Imaging in patients for whom a resting EKG may be inadequate to identify changes compatible with coronary artery disease.

Indications and Limitations of Coverage

Because this device is still considered investigational pending additional data on its clinical efficacy/sensitivity and value as a diagnostic tool, program payment may not be made for its use at this time.

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Page Last Modified: 4/23/2009 7:26:58 AM

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