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View Public Comments for Computed Tomographic Angiography (CAG-00385N)


 
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View comments for periods:    06/13/2007 - 07/13/2007    12/13/2007 - 01/12/2008   

 
 Public Comment Period: 12/13/2007 - 01/12/2008
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Commenter: Abdullah, Edward
Title: Physician
Organization: Los Angeles Cardiology Associates
Date: 01/10/2008
Comment:

Patient care will be adversely affected if the
proposed restrictions and rules for cardiac CTA
are adopted.

1. CMS has not examined the full impact
this proposal will have on the Medicare
beneficiary. If the driver f   More...



Commenter: Abordo, Melecio
Title: President
Organization: Family Medical Clinic
Date: 01/11/2008
Comment:

CTA is a truly revolutionary tool in the diagnosis of coronary artery
disease. It is faster, non-invasive, less expensive and a very
accurate way of diagnosing coronary artery disease and other non-
cardiac causes of chest pain. It will   More...



Commenter: Agapitov, Alexei
Organization: University of Iowa
Date: 01/04/2008
Comment:

1. There is no credible published evidence to suggest that
any inappropriate use of cardiovascular CT occurs. In fact, there
is rapidly accumulating body of evidence suggesting benefit to
patients from thi stechnology. It does no   More...



Commenter: Ahsan, Chowdhury
Title: DIRECTOR, CATH LAB, UNIVERSITY MEDICAL CENTER
Organization: NEVADA HEART AND VASCULAR IMAGING
Date: 01/11/2008
Comment:

CT Angiography has been of great help to identify
or ensure:
a. who in the low/intermediate group would need
active medical attention to prevent myocardial
infarction by visualizing the plaques. These
patients typically have ne   More...



Commenter: AILIANI, RAJU
Title: MD
Organization: GUNDERSEN LUTHERAN HEART INSTITUTE
Date: 01/10/2008
Comment:

The preliminary NCD is not appropriate. The
authors of the prelimiary NCD themselves agree
that the evidence is promisng for two clinical
indications namely a symptomatic patient with
chronic stable angina and intermediate risk for   More...



Commenter: Alcorn-Kell, Nancy
Title: Regional Director
Organization: Cardiovascular Associates
Date: 01/10/2008
Comment:

lectronic submission)




RE: Proposed Decision Memo for Computed
Tomographic Angiography (CAG-00385N)

I represent CARDIOVASCULAR ASSOCIATES, SC, which
provides Cardiology services to the greater Elk
Grove Village   More...



Commenter: Alperovich, Alexander
Title: Cardiologist
Organization: Apex Cardiology
Date: 01/12/2008
Comment:

I am a practicing interventional cardiologist. I
am very disturbed by the CMS reluctance to make
available new progressive technology to the
American public. At last we got the noninvasive
tool letting us literally see coronary ar   More...



Commenter: Alson, Mark
Title: Secretary
Organization: California Radiological Society
Date: 01/11/2008
Comment:

We believe that the proposed NCD is a poor
decision for Medicare beneficiaries for a number
of important reasons:

. We disagree with CMS’ conclusions in this
proposed coverage determination. We believe that
if implemented, the    More...



Commenter: ALVARADO, HORTENCIA
Date: 01/11/2008
Comment:

I am writing to express my concern over a
National Coverage Decision (NCD) proposal that
CMS is making that will limit an important and
potentially lifesaving test to Medicare
beneficiaries.



Commenter: Anderson, Dr. Jon E.
Title: Radiologist
Organization: Lake Medical Imaging
Date: 01/10/2008
Comment:

I oppose the proposed national coverage policy
for coronary CTA for the following reasons:

• We disagree with CMS’ conclusions in the
proposed Coronary Artery CTA (CCTA) coverage
determination and believe that if implemented,    More...



Commenter: Anderson, Brian
Title: M.D.
Organization: Radiology Associates of Clearwater
Date: 01/10/2008
Comment:
  • We disagree with CMS’ conclusions in the proposed Coronary Artery CTA (CCTA) coverage determination and believe that if implemented, the policy will be profoundly negative for Medicare beneficiaries by limiting their    More...


Commenter: Anderson, Jon
Date: 01/10/2008
Comment:

I disagree with CMS’ conclusions in this
proposed coverage determination and believe that
if implemented, the policy would have a
profoundly negative impact on Medicare
beneficiaries by limiting access for clinically
appropria   More...



Commenter: Angel, David
Date: 01/10/2008
Comment:

This is not how to balance a budget. CCTA will
save money by less Caths done.



Commenter: Arbab-Zadeh MD, Armin
Title: Assistant Professor of Medicine
Organization: Johns Hopkins University School of Medicine
Date: 01/10/2008
Comment:

Steve E. Phurrough, MD, MPA
Director, Coverage and Analysis Group, CMS
Re: CTA
Mailstop C1-09-06
7500 Security Blvd.
Baltimore, MD 21244-1850

Dear Dr. Phurrough:

With interest we read your Pro   More...



Commenter: Aronson, Naomi
Title: Executuve Director, TEC
Organization: Blue Cross and Blue Shield Assocoation
Date: 01/11/2008
Comment:

The Blue Cross and Blue Shield Association
(BCBSA), an association of 39 independent Blue
Cross and Blue Shield Plans that collectively
provide health insurance benefits to 99 million
Americans, appreciates the opportunity to provi   More...



Commenter: Auseon, Alex
Title: Assistant Professor of Clinical Medicine
Organization: The Ohio State University
Date: 01/09/2008
Comment:

I join my cardiology and radiology collegues in
agreeing that the proposed NCD for CT angiography
is overly zealous in its limitations and
strikingly premature. This diagnostic tool, when
used appropriately, serves as a highly acc   More...



Commenter: Backas, Paul
Date: 01/10/2008
Comment:

Limiting coverage of coronary CTA based upon old
data is the wrong decision, and will deny
patients access to a noninvasive and potentially
life-saving examination.



Commenter: Baganz, Mark
Date: 01/08/2008
Comment:

As a physician who has reviewed every major peer
reviewed article written in English about cardiac
CT that I am aware of and as a physician who
performed thousands of cardiac CT examinations, I
am very concerned at the proposal to limi   More...



Commenter: Baker, Jody
Title: Nurse Practitioner
Date: 12/21/2007
Comment:

As an Advanced Practice Nurse in cardiac
imaging, CCTA is the most excititng advancement
I have seen in twenty years. The literature
consistenty shows that CCTA is the most
sensitive and specific test for early diagnosis
of CAD   More...



Commenter: Baker, MD, James
Title: Clinical Professor
Date: 01/04/2008
Comment:

By taking advantage of the high negative
predictability of Coronary CTA, I have allowed my
patients to avoid invasive cardiac
catheterizations, saving resources and limiting
complications. If reimbursement is unavailable,
our    More...



Commenter: Baldwin, Dr. James
Date: 01/12/2008
Comment:

As a cardiologist practicing in Florida, after
adding coronary CT angiography to my practice, I
have been able to reduce by over 40% the number
of cardiac catheterizations performed on Medicare
beneficiaries. If Medicare coverage    More...



Commenter: Baliga, R.
Date: 01/10/2008
Comment:

Cardiac CT is an excellent modality for coronary
angiography, mapping of atrial fibrillation and
peripheral vascular disease. It avoids
unnecessary cardiac catheterization and provides
more information that treadmill stress testing   More...



Commenter: Bansal, Sharad
Date: 01/11/2008
Comment:

Please reconsider and stop the proposed cut for
cardiac CT.



Commenter: bansal, vipin
Date: 01/09/2008
Comment:

do not agree with NCD for coronary CTA. Many recent studies
support the use of this non-invasive test. Many patients can
avoid a dangerous and costly angiogram if coronary CTA is more
widely available.

Banning self-referral by   More...



Commenter: Banull, Craig
Organization: Radiology Associates of Clearwater
Date: 01/10/2008
Comment:
  • We disagree with CMS’ conclusions in the proposed Coronary Artery CTA (CCTA) coverage determination and believe that if implemented, the policy will be profoundly negative for Medicare beneficiaries by limiting their    More...


Commenter: barbat, marilyn
Date: 01/10/2008
Comment:

(electronic submission)




RE: Proposed Decision Memo for Computed
Tomographic Angiography (CAG-00385N)

I represent CARDIOVASCULAR ASSOCIATES, SC, which
provides Cardiology services to the greater Elk
Grove Villa   More...



Commenter: Barghouthi, Thair
Organization: Raleigh Heart Clinic, Inc.
Date: 01/12/2008
Comment:

To Whom it May Concern,

I am greatly troubled by the new proposed CME NCD
on cardiac CTA.

The proposed NCD does not fully reflect the
current state of evidence in support of CCTA in
regard to symptomatic patients with ch   More...



Commenter: Barnard, Lester
Title: Equipment Specialist, US Army Civilian
Organization: Department of Defense
Date: 01/12/2008
Comment:

According to the Huntsville Times newspaper and
Dr Michael Ridner of the Heart Center, CT scans
for surgery free look inside the heart is the way
to go. According to the Article Dr. Ridner has
completed immense research into this a   More...



Commenter: Baron, James
Date: 01/12/2008
Comment:

Diagnosis of Coronary Artery Disease (evaluation
of disease) is easily accomplished in a NON-
INVASIVE manner with CTA. Why put patients
through an invasive study fpr this purpose?
Medicare NCD should NOT overturn any LCD which
   More...



Commenter: Bauch, Terry
Organization: UT Health Science Center at San Antonio
Date: 12/21/2007
Comment:

I direct a Cardiac CT training program in a UT
Cardiology Fellowship. We review our Coronary CT
images, cath correlations, and clinical outcomes
every week.

I suggest a national registry, and mandated local
quality assurance pro   More...



Commenter: Baum, Allen
Title: Vice President
Organization: Cardiology Clinic of San Antonio
Date: 01/07/2008
Comment:

To whom it may concern: I am a practicing
cardiologist and although the evidence based
studies are not currently available for 64 slice
CTA of the coronary arteries, I have found it to
be extraordinarily useful in practice. Since we<   More...



Commenter: Bauman, John
Date: 01/12/2008
Comment:

I am a board certified internist, radiologist
and nuclear medicine physician. I have
evaluated coronary artery disease one way or
another for the last 25 years. Your decision is
narrow and not supported by the clinical
exper   More...



Commenter: Baumann, Mary Lou
Date: 01/10/2008
Comment:

(electronic submission)




RE: Proposed Decision Memo for Computed
Tomographic Angiography (CAG-00385N)

I represent CARDIOVASCULAR ASSOCIATES, SC, which
provides Cardiology services to the greater Elk
Grove Villa   More...



Commenter: beahrs, margaret
Date: 01/05/2008
Comment:

I have learned with great concern about the
restrictions that are anticipated to take place
3/08 on coverage for the modality CTA as it is
used in the diagnosis of CAD. I believe these
restrictions are premature and unwarranted as   More...



Commenter: Bear, Phil
Date: 01/03/2008
Comment:

To Whom It May Concern:



I appreciate the opportunity to comment on the
proposed NCA for Computer Tomographic Angiography
(CAG-00385N). I am writing to express my concern
for the following.



The proposed    More...



Commenter: Beauchamp, R. Drake
Title: partner, physician radiologist
Organization: Radiology and Imaging of South Texas
Date: 01/10/2008
Comment:

I have been performing CT coronary angiography
for almost two years. I have personally scanned
and processed several hundred patient cases and
found CT coronary angiography to be an excellent
diagnostic tool. In most cases (proba   More...



Commenter: Benjamin, Mark
Title: M.D.
Organization: Radiology Associates of Clearwater
Date: 01/10/2008
Comment:
  • We disagree with CMS’ conclusions in the proposed Coronary Artery CTA (CCTA) coverage determination and believe that if implemented, the policy will be profoundly negative for Medicare beneficiaries by limiting their    More...


Commenter: Benton, Steven
Title: Cardiologist
Date: 01/03/2008
Comment:

Cardiac CT angiography is a very valuable tool
to avoid unnecesary invasive coronary
angiography in patients with stress tests that
are suspected to be inaccurate, but abnormal.
The proposed CMS rules will actually increase
the   More...



Commenter: Berland, Karl
Date: 01/10/2008
Comment:

I urge that a NCD excluding reimbursement for
CTA (except as indicated in the draft) be
delayed for a period of 12 months. Quality
research is being presented now and into the
near term future on the ability of this test to
be    More...



Commenter: Berman, Daniel
Title: Director, Cardiac Imaging
Organization: Cedatrs-Sinai Medical Center
Date: 01/12/2008
Comment:

I am a practicing cardiologist and nuclear
medicine specialist (California license number A
23844) and director of nuclear cardiology and
cardiac imaging at Cedars-Sinai Medical Center in
Los Angeles. A full professor in residence    More...



Commenter: Bertuso, John
Date: 01/12/2008
Comment:

The proposed rules for national coverage of CCTA should be withdrawn and re-done in my view. They will make it nearly impossible for Medicare Beneficiaries to utilize this technology. If that occurs they will be deprived of new technology which ma   More...



Commenter: Bestermann Jr. MD, William
Title: Medical Director, Vascular Medicine Center
Organization: Holston Medical Group
Date: 01/10/2008
Comment:

For many patients, the decision not to cover
coronary CTA will turn out to be quite
literally "dead wrong." The use of coronary CTA
is one piece of a sweeping change of the
scientific understanding of coronary disease.
The sc   More...



Commenter: Bhandari, Anil
Title: Physician
Organization: Los Angeles Cardiology Associates
Date: 01/10/2008
Comment:

Patient care will be adversely affected if the
proposed restrictions and rules for cardiac CTA
are adopted.

1. CMS has not examined the full impact
this proposal will have on the Medicare
beneficiary. If the driver f   More...



Commenter: Bhatia, Dr. Manoj
Title: Radiologist
Organization: Lake Medical Imaging
Date: 01/10/2008
Comment:

I oppose the proposed national coverage policy
for coronary CTA for the following reasons:

• We disagree with CMS’ conclusions in the
proposed Coronary Artery CTA (CCTA) coverage
determination and believe that if implemented,    More...



Commenter: Biederman, Bruce
Date: 01/12/2008
Comment:

I am a board certified radiologist practicing in California. I have
personally performed over 500 coronary CTAs. I cannot stress
enough the benefit of this examination to prevent sudden cardiac
death and as a tool of performing preve   More...



Commenter: Bies, Roger
Title: Cardiologist
Organization: Central Arizona Heart Specialists
Date: 12/24/2007
Comment:

I do not agree with the proposed coverage
decision by Medicare for cardiac CT. The decision
does not appear to fully recognize the most up to
date published information on the utility of CTA.
I am an interventional cardiologist and   More...



Commenter: Biggs, Thomas
Date: 01/03/2008
Comment:

I am very concerned about the suggested changes
in the reimbursement for Cardiac CT angiography.
I am an invasive/interventional cardiologist. I
a have no doubt that CTA has an important role in
the optimal care of patients with    More...



Commenter: Birrenkott, Margaret
Title: Director
Organization: University of Wisconsin School of Medicine & Public Health
Date: 01/09/2008
Comment:

I disagree with CMS' conclusion in the proposed
coverage determination. If iplemented, the
policy will negatively impact Medicare
beneficiaries by limited access for clinically-
appropriate indications with this technology.
T   More...



Commenter: bishop, harry
Date: 01/12/2008
Comment:

I am a cardiologist in a 40 plus group and have
been practicing since 1981. Cardiac CTA is one of
the most useful diagnostic technologies I have
seen developed in cardiology. Lack of coverage
will result in:
1. Use of more invas   More...



Commenter: Blakeley, Janice
Title: Dir. of Risk Mgmt. Exec Dir. Interventional Serv
Organization: Lake Medical Imaging and Vascular Institute
Date: 01/10/2008
Comment:

I strongly disagree with CMS' conclusions
regarding this proposal. If implemented I
believe there will be a huge negative impact on
Medicare beneficiaries by limiting access to
clinically appropriate technology. This
proposa   More...



Commenter: Block, Terence
Title: Cardiologist
Organization: Valley Medical Center
Date: 01/07/2008
Comment:

To Whom it May Concern,

I am troubled and concerned by the new proposed
CMS NCD on cardiac CTA.

The proposed NCD does not fully reflect the
current state of evidence in support of CCTA in
regard to symptomatic patients with   More...



Commenter: Blue, Christopher
Title: Registered CT Technologist
Organization: Association of Alexandria Radiologists, PC
Date: 01/08/2008
Comment:

you have got to be kidding. Coronary CTAs are a
necessity for patients who can not have coronary
angiograms, or surgery. without coronary CTAs,
how can we safely image the heart?



Commenter: Boehm, Tracy
Title: RN
Organization: Illinois Heart and Vascular
Date: 01/10/2008
Comment:

RE: Proposed Decision Memo for Computed
Tomographic Angiography (CAG-00385N)

We represent Illinois Heart and Vascular which
provides Cardiology services to the greater
Chicago land area. We have 27 physicians, 92
employees a   More...



Commenter: Bohman, Diane
Date: 01/09/2008
Comment:

The Coronary CT is a cheaper and very detailed
test that avoids the more expensive invasive
tests, I think you should reconsider changing
your payment structure on this test and allow
Medicare patients to have the non-invasive
   More...



Commenter: Bohnert, Brad
Date: 01/10/2008
Comment:

I am writing in regards to the limitations that are being proposed on cardiac CTA.

In the last decade, there have been significant advances in noninvasive vascular imaging using CTA and MRA. These advances have greatly enhanced patient c   More...



Commenter: Borg, Mary Jane
Organization: Illinois Heart and Vascular
Date: 01/10/2008
Comment:

RE: Proposed Decision Memo for Computed Tomographic Angiography (CAG-00385N)

We represent Illinois Heart and Vascular which provides Cardiology services to the greater Chicago land area. We have 27 physicians, 92 employe   More...



Commenter: Bornitz, Tim
Date: 01/10/2008
Comment:

I personally know of 3 people that had cardiac
screens done on a CT and severe blockage was
discovered. If not for this exam, their first
indication would have been a severe heart attach.

We can't just have this tool available   More...



Commenter: Borromeo, Salvador
Title: CARDIOLOGIST
Organization: HEART CENTER OF NEVADA
Date: 01/11/2008
Comment:

I will like to comment on the utility of Cardiac CTA for patients
in a non-acute setting wherein it can eliminate the use of cardiac
catheterizations in moderate risk patients that are prone to have
false positive stress tests. If the c   More...



Commenter: Bourland, Barbara
Title: M.D.
Organization: Radiology Associates of Clearwater
Date: 01/10/2008
Comment:
  • We disagree with CMS’ conclusions in the proposed Coronary Artery CTA (CCTA) coverage determination and believe that if implemented, the policy will be profoundly negative for Medicare beneficiaries by limiting their    More...


Commenter: Bowe, Sandie
Date: 01/09/2008
Comment:

In all new technologies, it had been difficult to
prove the value of new ways of imaging. I
remember when CT Scans of the Abdomen was
considered non-payable and now its invaluable in
the treatment and outcome of a patient.
I fe   More...



Commenter: Boxbaum, Allen
Date: 01/11/2008
Comment:

THis is another example of CMS trying to control
costs without knowing the real use of
technology. As a healthcare executive I have
already seen evidence that the presence of WELL
RUN CTA programs, lowers use of other
modaliti   More...



Commenter: Boxt, Lawrence
Title: Director of Cardiac MRI and CT
Organization: North Shore University Hospital
Date: 01/06/2008
Comment:

Cardiac CTA provides a fast, safe, and highly accurate means of
excluding coronary heart disease in symptomatic patients with
low or intermediate risk. CTA triages these patients away from
the catheterization laboratory, allowing resou   More...



Commenter: Bradford, Pamela
Date: 01/11/2008
Comment:

CT Angiography is a valuable tool for Physicians
to use to discern the need for cardiac surgical
intervention, or catheter lab procedure. The
value of CTA has been demonstratd at many medical
facilities around the world. If Medicar   More...



Commenter: Brake, Joel
Date: 01/09/2008
Comment:

I am a medical provider in Missoula, MT. I have seen coronary CTA
markedly limit the number of needless catheter studies at our
institution. In my mind it will save money going forward and help
limit expensive self-referral.



Commenter: Broshears, Mary
Date: 01/12/2008
Comment:

Why not pay for a less expensive, less invasive
alternative to cardiac angiography? In this day
and age of cutting benefits, it does not make
sense to cut this one. A cardiac catheterization
costs four times as much!



Commenter: Brosseau, Pat
Date: 01/11/2008
Comment:

I believe the proposed Decision Memo for CTA is
extremely poor public policy. CCTA is a valuable
tool that is less expensive and poses less risk
to the patient than the current standard of care,
invasive cardiac catheterization.    More...



Commenter: Brown, Stephen
Title: MD
Organization: Utah Valley Radiology Associates
Date: 01/09/2008
Comment:

I am opposed to the proposal to limit coronary
CTA. CCTA has already made a significant
contribution in quality of health care to many of
my patients. This test has discovered severe
coronary disease in many of my patients that was   More...



Commenter: Brunst, Steve
Date: 01/10/2008
Comment:

The proposed NCD should be withdrawn. If it is not withdrawn,
substantial modifications should be made to provide coverage
for appropriate indications and populations.
The proposed NCD does not adequately reflect the current state
o   More...



Commenter: Budoff, Matthew
Title: President
Organization: Society of Atherosclerosis Imaging and Prevention
Date: 01/12/2008
Comment:

We read this proposed NCD with great
disappointment. What CMS is proposing is not
only unprecedented, but potentially seriously
harmful to the Medicare population. It is
remarkable that CT scanning of every body part
(excep   More...



Commenter: Bujenovic, Steven
Title: Director, Nuclear Medicine
Organization: Our Lady of the Lake RMC
Date: 01/11/2008
Comment:

Dear Sir/Madam;
As a physician who sees patients daily for
cardiovascular testing, I see that cardiac CTA
has demonstrated advantages beyond most of our
current non-invasive exams. We can now
characterize arterioslerotic plaque    More...



Commenter: Burstein, Steven
Title: Physician
Organization: Los Angeles Cardiology Associates
Date: 01/10/2008
Comment:

Patient care will be adversely affected if the
proposed restrictions and rules for cardiac CTA
are adopted.

1. CMS has not examined the full impact
this proposal will have on the Medicare
beneficiary. If the driver f   More...



Commenter: Byrnes, Andrew
Date: 01/11/2008
Comment:

This is necessary and natural progression. Why
not take advantage of technology to better
patient care and have it be reimbursable.



Commenter: Calnon, Dennis
Title: Director, Nuclear Imaging
Organization: MidOhio Cardiology and Vascular Consultants
Date: 01/04/2008
Comment:

I am concerned that the premature implementation
of a restrictive NCD for CCTA will negatively
impact the health of Medicare benficiaries.
Clinical outcomes data supporting this exciting
new diagnostic tool are rapidly accummulati   More...



Commenter: Campbell MD, Cam
Date: 01/10/2008
Comment:

Thank you for the opportunity to respond to the latest CMS proposal for coronary CTA.

The proposed NCD should be withdrawn. If it is not withdrawn, substantial modifications should be made to provide coverage for appropriate indications    More...



Commenter: Cannom, David
Title: Physician
Organization: Los Angeles Cardiology Associates
Date: 01/10/2008
Comment:

Patient care will be adversely affected if the
proposed restrictions and rules for cardiac CTA
are adopted.

1. CMS has not examined the full impact
this proposal will have on the Medicare
beneficiary. If the driver f   More...



Commenter: Cannon, Christopher
Date: 01/12/2008
Comment:

It is very important that you reconsider
proposed changes in reimbursement for cardiac
CT. In fact coverage for this procedure should
expand. CMS will cripple or kill a very
promising tool which could provide early
diagnosis a   More...



Commenter: Captain, Jessica
Date: 01/10/2008
Comment:

We disagree with CMS’ conclusions in the
proposed Coronary Artery CTA (“CCTA”) coverage
determination and believe that if implemented,
the policy will be profoundly negative for
Medicare beneficiaries by limiting their access <   More...



Commenter: Carbo, Nicole
Date: 01/10/2008
Comment:

It is wrong to limit CCTA, a non-invasive test
that gives a 99% negative predictive value.
This would not save money as CCTA cost
SIGNIFICANTLY less than a cardiac cath. Also,
30% of cardiac caths are negative. This means
su   More...



Commenter: Carell, Edgar
Title: MD
Organization: Illinois Heart and Vascular
Date: 01/07/2008
Comment:

As an interventinal cardiologist involved with
cardiac CT for almost 3 years the potential
decision to severely restrict the availablilty of
cardiac CT to Medicare patients in clinical
practice is a huge and disappointing mistake.    More...



Commenter: Carlevato, Nicholas
Organization: Great Basin Imaging
Date: 01/08/2008
Comment:

January 8, 2008


Dear Centers for Medicare and Medicaid Services:

I strongly urge the Centers for Medicare and
Medicaid Services (CMS) to reconsider its
proposal and National Coverage Decision (NCD)
regarding coronary    More...



Commenter: Carnaghi, Jennifer
Title: Registered Nurse
Organization: Illinois Heart and Vascular
Date: 01/10/2008
Comment:

RE: Proposed Decision Memo for Computed
Tomographic Angiography (CAG-00385N)

We represent Illinois Heart and Vascular which
provides Cardiology services to the greater
Chicago land area. We have 27 physicians, 92
employees a   More...



Commenter: Carol Grigg, MD, Johnsie
Date: 01/12/2008
Comment:

This one cut, if enacted, will likely begin the
end of solo medical practice in America, and many
other middle age physicians, like myself, with a
good 20 years ahead of them, will likely retire
early, leaving patients without the    More...



Commenter: Carolan, Frederick
Title: M.D.
Organization: Radiology Associates of Clearwater
Date: 01/10/2008
Comment:
  • We disagree with CMS’ conclusions in the proposed Coronary Artery CTA (CCTA) coverage determination and believe that if implemented, the policy will be profoundly negative for Medicare beneficiaries by limiting their    More...


Commenter: Carroll, John D.
Title: Director, Cardiac and Vascular Center
Organization: University of Colorado Hospital
Date: 01/10/2008
Comment:
  • I am a senior faculty member of the University of Colorado Division of Cardiology and a Professor of Medicine in the School of Medicine. I serve as the medical director of the Cardiac and Vascular Center at the University o   More...


Commenter: Cavanaugh, MD, Brendan
Organization: New Mexico Heart Institiute
Date: 01/09/2008
Comment:

To whom it may concern,

I am writing this memo on behalf of the New
Mexico Heart Institute and the 45,000 patients
we serve in the State of New Mexico in
opposition of decision by CMS regarding Computed
Tomographic Angiograp   More...



Commenter: Cavett, Linda
Title: REP
Organization: Cardiovascular Associates
Date: 01/10/2008
Comment:




RE: Proposed Decision Memo for Computed
Tomographic Angiography (CAG-00385N)

I represent CARDIOVASCULAR ASSOCIATES, SC, which
provides Cardiology services to the greater Elk
Grove Village/Hoffman Estates, IL area. We   More...



Commenter: Ceballos, Thomas
Title: M.D.
Organization: Radiology Associates of Clearwater
Date: 01/10/2008
Comment:
  • We disagree with CMS’ conclusions in the proposed Coronary Artery CTA (CCTA) coverage determination and believe that if implemented, the policy will be profoundly negative for Medicare beneficiaries by limiting their    More...


Commenter: Chang, Dr. Pairoj S.
Title: Radiologist
Organization: Lake Medical Imaging
Date: 01/10/2008
Comment:

I oppose the proposed national coverage policy
for coronary CTA for the following reasons:

• We disagree with CMS’ conclusions in the
proposed Coronary Artery CTA (CCTA) coverage
determination and believe that if implemented,    More...



Commenter: Charlat, Martin
Date: 01/10/2008
Comment:

The proposed NCD should be withdrawn. If it is not withdrawn,
substantial modifications should be made to provide coverage
for appropriate indications and populations.
The proposed NCD does not adequately reflect the current state
o   More...



Commenter: Charnock, Ginny
Title: MD
Date: 01/08/2008
Comment:

I am a radiologist who developed a Coronary CT
Angiography program at a hospital where I
recently worked and am currently reading CCTA at
another hospital where the program was instituted
by the cardiologists, who also read the stu   More...



Commenter: Chaudhuri, Pradipta
Date: 01/04/2008
Comment:

Dear Sir: It is premature to propose a new set of
coverage criteria without a thorough review of
the available published evidence. This is
especially true as data is rapidly accumulating
for CCTA and at a much faster pace than many   More...



Commenter: Chauhan, Manish
Date: 01/08/2008
Comment:

Changes in reimbursement or coverage as proposed
will hamper care of patients at risk or those
with this #1 killer disease. Please consider
widening coverage to a larger subset of the
population to help physicians better treat and    More...



Commenter: Cherry, David
Date: 01/11/2008
Comment:

RE: Proposed Decision Memo for Computed
Tomographic Angiography (CAG-00385N)



I represent CARDIOVASCULAR ASSOCIATES, SC, which
provides Cardiology services to the greater Elk
Grove Village/Hoffman Estates, IL area. W   More...



Commenter: Cherry, Jennifer
Date: 01/11/2008
Comment:

RE: Proposed Decision Memo for Computed
Tomographic Angiography (CAG-00385N)



I represent CARDIOVASCULAR ASSOCIATES, SC, which
provides Cardiology services to the greater Elk
Grove Village/Hoffman Estates, IL area. W   More...



Commenter: Cherry, Stephen
Date: 01/12/2008
Comment:

Although potentially I could lose income myself from loss of cardiac caths being replaced by CT angiograms in certain patients, nevertheless CT is a beneficial technology that should be available to patients and reimbursed.



Commenter: CIGARROA, RICARDO
Title: MD
Date: 01/11/2008
Comment:

I am writing to express my concern over a
National Coverage Decision (NCD) proposal that
CMS is making that will limit an important and
potentially lifesaving test to Medicare
beneficiaries.

R CIGARROA



Commenter: Clark, Craig
Date: 01/09/2008
Comment:

Writing as a Radiologist-Attorney-Economist, I find your
proposal unusually ill informed, and the magnitude of the
proposed changes as unwise. In appropriately selected patient
populations, coronary CTA performed with 64 detector or <   More...



Commenter: Cline, Marsha
Title: M.D.
Organization: Radiology Associates of Clearwater
Date: 01/10/2008
Comment:
  • We disagree with CMS’ conclusions in the proposed Coronary Artery CTA (CCTA) coverage determination and believe that if implemented, the policy will be profoundly negative for Medicare beneficiaries by limiting their    More...


Commenter: Coates, Glenn
Title: Director, Body MRI Services
Organization: Wake Radiology
Date: 01/10/2008
Comment:

I would like to document my shock concerning the
CMS proposed NCD on Coronary CTA. As a healthcare
provider, I have seen many imaging techniques of
questionable value come and go. It is amazing to
me that at test such as Coronary C   More...



Commenter: Cole, Jason
Title: Medical Director, Cardiovascular CT
Organization: Cardiology Associates of Mobile; University of South Alabama Medical Center
Date: 01/09/2008
Comment:

I am a cardiologist involved in clinical
practice, clinical trials, and outcomes studies
on cardiovascular CT. I would again strongly
recommend that CMS consider expert opinion from
organizations such as the ACC, ACR, and SCCT in <   More...



Commenter: Comunale, Raymond
Title: General partner
Organization: West Mifflin Imaging Associates, LP
Date: 01/10/2008
Comment:

I am writing as the manager and general partner
of an out patient imagomg center in the
Pittsburgh area. We have purchased a 64 slice
scanner and have been doing corinary CTA for over
a year. We have had extensive training,have bee   More...



Commenter: conner, robert
Date: 12/23/2007
Comment:

I am a member of the SCCT (Society of
Cardiovascular CT) and have performed a total of
approximately 400 CCTAs (Cardiac CT Angiograms),
with significant clinical and CA (Coronary
Angiogram) follow-up since August 2005, utilizi   More...



Commenter: Connolly, Agatha
Title: Medical Coder/Biller
Date: 01/10/2008
Comment:

RE: Proposed Decision Memo for Computed
Tomographic Angiography (CAG-00385N)

I represent Cardiovascular Management of Illinois
which provides Cardiology services to the greater
(name of city/state) area. We have (XX)
physici   More...



Commenter: conroy, joseph
Date: 01/11/2008
Comment:

Please do not move foward with NCD for cardiac ct
this would be devistating to our country



Commenter: Cook, Tom
Date: 01/11/2008
Comment:

CCTA is gaining clinical acceptance on a daily
basis. It offers physicians a diagnostic tool
that is now considered an acceptable alternative
to cardiac cath when deciding the best clinical
course of treatment. Why would you now ta   More...



Commenter: Corbett, David
Date: 01/09/2008
Comment:

Dear Sirs,

Please make every effort to see to it that this
procedure is made available to those of us that
live in the rural areas of this country. We have
paid our taxes and made contributions toward the
betterment of this    More...



Commenter: Cordner, David
Date: 12/15/2007
Comment:

I cannot believe that are going to stop payment for the Cardiac CT which is priced at approx. $900 and replace the procedure with an Angiogram for a price of approx. $10,000.  Each test gives you the exact same results.    More...



Commenter: Corn, Carolyn
Title: Director of Nuclear Cardiology
Organization: Oklahoma Cardiovascular Associates
Date: 01/08/2008
Comment:

To Whom It May Concern:

I am seriously concerned about the premature
proposal concerning restrictions on reimbursement
for cardiac CTA. The conclusions reached by the
panel and reflected in the proposed CME NCD do
not accur   More...



Commenter: Crawford, Fred
Date: 01/11/2008
Comment:

I am writing to express my concern over a
National Coverage Decision (NCD) proposal that
CMS is making that will limit an important and
potentially lifesaving test to Medicare
beneficiaries.



Commenter: Cregan, Kevin
Title: Radiologist
Organization: Wayne Radiologists, P.A.
Date: 01/08/2008
Comment:

I am shocked at CMS' proposal to eliminate
reimbursement for coronary CTA (CCTA). This is
one of the most significant imaging advancements
to occur in the last decade. As a
fellowship-trained radiologist with 12 months of
experie   More...



Commenter: Crepps, Jr. MD, Joseph Thomas
Date: 01/12/2008
Comment:

As a vascular surgeon, I treat many complications
from an old fashioned cardiac catheterization
where the patient actually has their artery
punctured. I have seen numerous deaths, strokes,
amputations, kidney failure, and arteries    More...



Commenter: Crescenti, Chris
Title: IT Director
Organization: CMI
Date: 01/10/2008
Comment:

RE: Proposed Decision Memo for Computed
Tomographic Angiography (CAG-00385N)

I represent CARDIOVASCULAR ASSOCIATES, SC, which
provides Cardiology services to the greater Elk
Grove Village/Hoffman Estates, IL area. We have
19   More...



Commenter: Crisp, John
Date: 01/08/2008
Comment:

This is a setback for advanced technology in
healthcare for improving the health of America.



Commenter: Cundey, David
Organization: Carolina Heart & Vascular Center
Date: 01/11/2008
Comment:

I am extremely concerned over the proposed NCD
decision regarding eliminating reimbursement for
CCTA in the absence of a clinical trial. I have
used CCTA in my private practice of 35 years for
the past year and a half. It has chang   More...



Commenter: Cunningham, William
Date: 01/11/2008
Comment:

The proposal for CTA reimbursement is too
stringent. If you need to regulate this
procedure, limit the reimbursement to hospitals.
Stand alone clinics and outpatient facilities
are probably diluting the market and over
prescrib   More...



Commenter: Curtin, Ronan
Title: Associate Cardiologist
Organization: Cleveland Clinic
Date: 01/12/2008
Comment:

The proposed NCD for coronary CTA should be
withdrawn or significantly modified to provide
coverage for patients who can benefit from this
important new non-invasive test.
Numerous peer reviewed studies have demonstrated
the hig   More...



Commenter: Curtis, John
Date: 01/11/2008
Comment:

Computed Tomographic Angiography can save patient
morbidity and mortality by replacing catheter
angiography with a non-invasive technique. The
negative predictive value of Computed Tomographic
Angiography is unequalled by any othe   More...



Commenter: Cusack, Lonnie
Title: CT Tech/Manager
Organization: Texas Cardiovascular Consultants
Date: 01/10/2008
Comment:

Please don't cut medicare prices on CTA
angiography. These patients would much rather
have a non-invasive test than an invasive one as
they get older. They are more frail and are more
opt to have complications. I am in the card   More...



Commenter: Czum, Julianna
Organization: Dartmouth-Hitchcock Medical Center
Date: 01/11/2008
Comment:

January 11, 2008



Joseph Chin, MD
JoAnna Baldwin, MS
Centers for Medicare and Medicaid Services
Department of Health and Human Services
P.O. Box 8014
Baltimore, MD 21244-8014

RE: Proposed Decision Memorandum for   More...



Commenter: Dafni, Ehud
Title: CEO
Organization: Arineta Ltd.
Date: 01/08/2008
Comment:

Dear Sirs,

Thank you for the opportunity to comment on the
proposed NCD for cardiac CT imaging.

I am a medical physicist with 17 years experience
in the development of multislice CT products,
from the Elscint dual slice    More...



Commenter: Danehy, Edward
Organization: Radiology Regional Center
Date: 01/12/2008
Comment:

1. My license number is NY 179000. I am a board
certified radiologist. This proposed Medicare
position re Cardiac CTA is the single worst
decision re the care of the American public I have
seen in 20 years of front line practice dealin   More...



Commenter: daneshrad, shaun
Title: MD, FACC, consultative cardiology
Date: 01/07/2008
Comment:

This modality has resulted in avoiding cardiac
cath and the risk associated and the cost of
hospitalization in a number of my patients, and I
am at a loss as to why there is a question about
its coverage. It has been a value in ev   More...



Commenter: Daniels, MD, Tyrone
Date: 01/12/2008
Comment:

It is almost criminal to consider restricting cta
to only the privately insured patients. Medicare
patients are in the process of being denied a new
and critical technology. Don’t allow this to
happen.



Commenter: Dannenbaum, Mark
Date: 01/11/2008
Comment:

CCTA can save patient morbidity and mortality by
replacing cath with a non-invasive technique.
The NPV of CCTA is unequalled by any other test.
Recent 64 slice and better literature confims
this and supports outstanding PPV as we   More...



Commenter: dao, ninh
Date: 01/09/2008
Comment:

Computed Tomographic Angiography (CTA) of the coronary is an excellent screening test with an approximate 99% negative predictive value. Widespread use of this test will lead to significant decrease in use of catheter angiogram of the coronary art   More...



Commenter: Davidson, Peggy
Title: Director of Radiology
Organization: Hills and Dales General Hospital
Date: 01/10/2008
Comment:

We are doing Cardiac CTA's at our facility and I
feel that they are having a good impact on the
way our patients Cardiac care is being followed.
The test is less invasive and the cost is lower
that other Cardiac testing. Althoug   More...



Commenter: Davis, Andrew
Title: M.D.
Organization: Radiology Associates of Clearwater
Date: 01/10/2008
Comment:
  • We disagree with CMS’ conclusions in the proposed Coronary Artery CTA (CCTA) coverage determination and believe that if implemented, the policy will be profoundly negative for Medicare beneficiaries by limiting their    More...


Commenter: Davis, Kirkland
Date: 01/10/2008
Comment:

I believe that it will be Medicare beneficiaries
who will suffer if the proposed National Coverage
Determination (NCD) is put in place for CCTA
(Computed Coronary Tomography Angiography).



As proposed, the NCD severely r   More...



Commenter: De Girolami, Daniele
Title: MD, FACC, FSCAI
Date: 01/10/2008
Comment:

To Whom It May Concern:

Anectdotally, a 79 year old man, post triple A
repair had a "normal" stress test before his
surgery. Post-operatively, he developed profound
gobal myocardial ischemia and cardiogenic shock.
He was tak   More...



Commenter: De Marco, Roland
Date: 01/08/2008
Comment:

Why would you not pay 1/3 as much for a coronary
CTA than a formal coronary angiogram? I am a 48
year male and I would prefer a cheaper non-
invasive and safer test.



Commenter: DEANO, DANILO
Title: Chief, Section of Cardiology
Organization: Saints Mary and Elizabeth Medical Center
Date: 01/09/2008
Comment:

This very restrictive ruling will severely impact
negatively on many of my patients - not only
those with high risks for developing coronary
artery disease but those patients with chest
pains of unknown etiology and with negative n   More...



Commenter: DeFrance, Tony
Title: Medical Director CVCTA Education
Organization: Board of Directors SCCT
Date: 01/07/2008
Comment:

As a physician who has been intimately involved
in cardiac CTA over the last six years I think it
is very unfortunate that CMS has approached
national coverage of this extremely valuable
modality in this way. I must say that this    More...



Commenter: DeJarnett, Jan
Date: 01/09/2008
Comment:

As a CT technologist, I have had the
opportunities to see what a difference Cardiac
CTA makes in the rapid diagnosis of coronary
artery disease by having performed a very simple
test for the patient to go through at a much
less   More...



Commenter: Delaney, Patrick
Organization: North Oaks Medical Center
Date: 01/10/2008
Comment:

Since I have incorporated coronary CT in my practice I have without a doubt been able to prevent patients from having to undergo invasive angiography. I do strongly believe that appropiate patient selection needs to be done and CT should not be us   More...



Commenter: DeLaurentis MD, Mark
Date: 01/11/2008
Comment:

Coronary CTA is beyond a shadow of a doubt, the single most
effective and effecient test to detect or rule out coronary artery
disease, the number one killer in the US. It costs about $1800
dollars to perform a stress test, which misse   More...



Commenter: Deliberto, Mary Ann
Date: 01/11/2008
Comment:

Please fund this very important tool in the
diagnostic process of our cardiac patients



Commenter: Demkovich, Susan
Title: RN
Organization: Illinois Heart and Vascular
Date: 01/11/2008
Comment:

RE: Proposed Decision Memo for Computed
Tomographic Angiography (CAG-00385N)

We represent Illinois Heart and Vascular which
provides Cardiology services to the greater
Chicago land area. We have 27 physicians, 92
employees a   More...



Commenter: demos, kathy
Date: 01/11/2008
Comment:

RE: Proposed Decision Memo for Computed
Tomographic Angiography (CAG-00385N)

We represent Illinois Heart and Vascular which
provides Cardiology services to the greater
Chicago land area. We have 27 physicians, 92
employees    More...



Commenter: Des Prez, Roger
Title: Cardiologist
Organization: OK Heart Institute
Date: 01/12/2008
Comment:

Re: Proposed Decision Memo for Coronary Computed
Tomography Angiography (CAG-00385)

Dear Sirs:

I am writing to comment about the proposed national
coverage determination for CT Angiography.

I object to Medicare’s    More...



Commenter: Desai MD, Amar
Date: 01/11/2008
Comment:

I belive CTA is extremely useful tool in managing chest pain syndrome and for diagnosis for intermediate risk for CAD and has near 100% predictive value for normal studies and can eliminate use of coronary angiography in normal subjects



Commenter: Dewan, Devaki
Title: M.D.
Organization: Radiology Associates of Clearwater
Date: 01/10/2008
Comment:
  • We disagree with CMS’ conclusions in the proposed Coronary Artery CTA (CCTA) coverage determination and believe that if implemented, the policy will be profoundly negative for Medicare beneficiaries by limiting their    More...


Commenter: Diaz, Dr. Rosendo
Title: Radiologist
Organization: Lake Medical Imaging
Date: 01/10/2008
Comment:

I oppose the proposed national coverage policy
for coronary CTA for the following reasons:

• We disagree with CMS’ conclusions in the
proposed Coronary Artery CTA (CCTA) coverage
determination and believe that if implemented,    More...



Commenter: Dieck, John
Title: Physician & CEO
Organization: Texas Cardiovascular Consultants
Date: 01/08/2008
Comment:

To whom it may concern:

I would like to express my concern over your
National Coverage
Decision (NCD) proposal for Cardiac CTA (CCTA).

In our practice, we have seen this technology
dramatically
benefit our patients in a   More...



Commenter: Diltz, Emily
Organization: East Tennessee Heart Consultants
Date: 01/08/2008
Comment:

I have found CTA very helpful in avoiding
unnecessary catheterizations, in assessing
symptomatic patients that are high risk for
cardiac catheterization complications eg stoke in
those with ventricular aneurysms and
revascularizatio   More...



Commenter: Dinh, Howard
Date: 01/10/2008
Comment:

The medicare proposal is groundless and has
little evidence to support its claims. It also
ignores enormous work of the American College of
Cardiology and other professional society's
tremendous efforts to comb through the literat   More...



Commenter: Dodge, James
Title: Medical Director
Organization: HeartCare - Providence Medford Medical Center
Date: 01/08/2008
Comment:

We very recently started performing cardiac CT
angiography. Our first three patients had chest
pain with risk factors and equivocal stress
tests. With cardiac CT angiography we were able
to determine that no significant coronary   More...



Commenter: Donlon, Vince
Title: Administrator
Organization: Cardiovascular Associates
Date: 01/11/2008
Comment:

January 11, 2008

Steve E. Phurrough, M.D., M.P.A.
Director, Coverage and Analysis Group
Office of Clinical Standards and Quality
Centers for Medicare & Medicaid Services
7500 Security Boulevard, Mail stop    More...



Commenter: Downey, Bridget
Title: CT Scan Supervisor
Organization: Frankford Healthcare System
Date: 01/11/2008
Comment:

We started to perform CT Coronary Angiograms 3
years ago. We have saved several of our
co-workers already and we would like to save more
people.
It is impossible to express the importance of
this test. I will try with two wor   More...



Commenter: Driskill, Margaret
Title: Social Worker
Date: 01/12/2008
Comment:

Women's Heart Health is largely ignored in
research. Women will agree to this diagonistic
procedure as it is non-invasive. Don't take away
such a breakthrough for women, PLEASE.



Commenter: Duman, Ralph
Date: 01/10/2008
Comment:

Do not limit coronary CT angiography. This is an
important non-invasive test to evaluate the
coronary arteries. The efficacy has been
established by multiple studies.



Commenter: Durday, Gary
Title: Administrator
Organization: Olympic Radiology
Date: 01/09/2008
Comment:

If you allow self referral of any kind, either
directly, through lease agreements, per click
agreements, or any other monetary lure to refer
patients for CTA, utilization will explode!!!!
Specificaly cardiologists and multi-specialty<   More...



Commenter: Durham, Richard
Date: 01/10/2008
Comment:

I agree the use of CCTA in various settings has the potential to be inappropriately used. Especially is this true when there is a financial incentive by the one ordering the test. I do believe, however when appropriately used it is a valuable diag   More...



Commenter: Edwards, Vance
Date: 01/10/2008
Comment:

When I first heard about the CMS proposal, I honestly thought it was a joke. I just can't believe that one of the most important imaging advancements in the last 20 years, one that radiologists have been striving for over years, is going to poten   More...



Commenter: Eichwedel, Sheri
Title: Charge Entry, Team Leader
Organization: CMI
Date: 01/11/2008
Comment:

RE: Proposed Decision Memo for Computed
Tomographic Angiography (CAG-00385N)

I represent Cardiovascular Management of Illinois
which provides Cardiology services to the greater
Chicagoland area. We have 19 physicians and serve <   More...



Commenter: Einstein, Andrew
Title: Assistant Professor
Organization: Columbia University
Date: 01/12/2008
Comment:

Dear Dr. Phurrough and colleagues,
Thank you for the opportunity to address the
proposed NCD. I am a cardiologist on the
full-time faculty of Columbia University Medical
Center and the lead author of the JAMA paper
addressing    More...



Commenter: Eisenberg, Lara
Date: 12/27/2007
Comment:

I believe that the proposed Medicare coverage
indications for CT coronary angiography (0146T)
are unnecessarily restrictive and will force
patients to pay out of pocket for this widely
used and needed test. Our LCD allows the study   More...



Commenter: Ekstrom, Jon
Title: President
Organization: Radiology Associates, P.C.
Date: 01/09/2008
Comment:

Cardiac CTA has been shown to have a very high
negative predictive value. For appropriately
selected patients (i.e., those symptomatic
patients with low risk for CAD), CCTA can reduce
the need and expense of conventional catheter-   More...



Commenter: Elder, MD, James
Date: 01/11/2008
Comment:

CCTA can save patient morbidity and mortality by
replacing cath with a non-invasive technique.
The NPV of CCTA is unequalled by any other test.
Recent 64 slice and better literature confims
this and supports outstanding PPV as we   More...



Commenter: Entel, Robert
Title: M.D.
Organization: Radiology Associates of Clearwater
Date: 01/10/2008
Comment:
  • We disagree with CMS’ conclusions in the proposed Coronary Artery CTA (CCTA) coverage determination and believe that if implemented, the policy will be profoundly negative for Medicare beneficiaries by limiting their    More...


Commenter: Epley, Kathryn
Title: Chief Administrative Officer
Organization: Radiology Consultants of Iowa, PLC
Date: 01/09/2008
Comment:

I strongly support coverage of Coronary CT
Angiography because it is a very good and valid
test that is not invasive and has low risk to
patients in terms of radiation exposure.

I recognize that the cost of this exam is of
g   More...



Commenter: Epstein, David
Title: MDFlorida Medicare Carrier Advisory Committee
Organization: ACR, FRS, FL CAC
Date: 01/11/2008
Comment:

From: David H. Epstein, MD
Medicare Carrier Advisory Committee
Representative Florida (Radiology)

To: CMS

Re: National Coverage Determination for
coronary CTA

Date: 1/10/2008


I urge CMS to reconsider it   More...



Commenter: Esseck, Elsie
Date: 01/10/2008
Comment:

  • I disagree with CMS’ conclusions in the proposed Coronary Artery CTA (CCTA) coverage determination and believe that if implemented, the policy will be profoundly negative for Medicare beneficiaries by limit   More...


Commenter: Everidge, Timothy
Title: Administrative Director, Ancillary Services
Organization: Medical Center of Arlington
Date: 01/11/2008
Comment:

I would oppose the suggested proposal due to lack
of information that would conclude extensive
academic evidence about patient care outcomes.
In addition, there would be additional cost
associated with performing the procedure via   More...



Commenter: Fagin, Roberta
Date: 01/09/2008
Comment:

I'm writing to express my concern over a NCD
proposal that CMS is making that will greatly
limit an imporrtant and potentially lifesaving
test to Medicare beneficiaries. They want to
stop pay8ing for Cardiac CT angiogram despite    More...



Commenter: Falco, M.D., Thomas
Date: 01/11/2008
Comment:

I am in a group of seven cardiologists on the
East End of Long Island and have been using
coronary CTA for two years. We have found
coronary CTA to be very helpful in diagnosing
patients with significant obstructive coronary
d   More...



Commenter: Falk, Robert
Title: Radiologist
Date: 01/08/2008
Comment:

I am writing to strongly urge CMS to re-examine
coverage for coronary CTA. As a practitioner in
the trenches utilizing this technology on a day
to day basis, it is apparent that proper
utilization of CTA saves lives and saves mone   More...



Commenter: fallah, juliet
Title: Department Chair Chest Radiology
Date: 01/12/2008
Comment:

I am a board certified interventional
radiologist. This proposed Medicare position re
Cardiac CTA is the single worst decision re the
care of the American public conceivable. Please
re-evaluate by including peer review literature <   More...



Commenter: Fanning, Gayle
Date: 01/11/2008
Comment:

RE: Proposed Decision Memo for Computed
Tomographic Angiography (CAG-00385N)

We represent Illinois Heart and Vascular which
provides Cardiology services to the greater
Chicago land area. We have 27 physicians, 92
employees a   More...



Commenter: Favela, Maribel
Title: Registered Nurse
Organization: Cardiovascular Associates
Date: 01/11/2008
Comment:

RE: Proposed Decision Memo for Computed Tomographic Angiography (CAG-00385N)

I represent CARDIOVASCULAR ASSOCIATES, SC, which provides Cardiology services to the greater Elk Grove Village/Hoffman Estates, IL area. We have 19 physicians,    More...



Commenter: Feuchtner, Gudrun
Organization: Medical University Innsbruck
Date: 01/12/2008
Comment:

• The proposed NCD does not adequately
reflect the current state of evidence in support
of CCTA.

• It does not include the most useful
clinical indications (e.g. patients low-
intermediate pre-test probability), because many   More...



Commenter: Feuerstein, Irwin
Date: 01/12/2008
Comment:

In our institution, we do cardiac CTA. With a
careful triage of patients who meet criteria and
would normally go to invasive catheterization
but are relatively low risk, these patients are
almost always cleared of obstructive coron   More...



Commenter: Fields, Greg
Title: Director, Diagnostic Imaging
Organization: Great River Medical Center
Date: 01/08/2008
Comment:

Studies have shown that coronary CTA can rule out
significant coronary artery disease less
invasively than conventional angiography, with a
negative predictive value of about 99%, and at a
lower cost compared to other exams. Studi   More...



Commenter: Finch, DO, James
Title: Staff Radiologist
Organization: Bay Imaging Associates, PLC
Date: 01/08/2008
Comment:

To restrict cardiac CTA payments is highly
arbitrary and may drastically affect health care
as we know it. No widely used imaging modality
in the last five decades has had to deal with an
NCD that was so premature or so restrictiv   More...



Commenter: fine, stephen
Date: 01/10/2008
Comment:

Coronary CTA is an extremely useful tool in the battle to combat mortality and morbidity due to cardiovascular disease. It can prevent more invasive procedures and their potential complications. The data will show that in the long run, coronary CT   More...



Commenter: Finley, John C.
Title: Cardiologist
Date: 01/12/2008
Comment:

Your possible indications for CTA to be studied
are not appropriate. A normal CTA reliable
excludes CAD in patients in whom atherosclerotic
CAD must be excluded by angiography. A person
with low liklihood of significant CAD clini   More...



Commenter: Finn, Kimberly
Title: Charge Entry Coder/Biller
Organization: CMI
Date: 01/11/2008
Comment:

RE: Proposed Decision Memo for Computed
Tomographic Angiography (CAG-00385N)

I represent Cardiovascular Management of Illinois
which provides Cardiology services to the greater
Chicagoland area. We have 29 physicians and serve <   More...



Commenter: Fisher, John
Title: M.D.
Organization: Radiology Associates of Clearwater
Date: 01/10/2008
Comment:
  • We disagree with CMS’ conclusions in the proposed Coronary Artery CTA (CCTA) coverage determination and believe that if implemented, the policy will be profoundly negative for Medicare beneficiaries by limiting their    More...


Commenter: fitzgerald, john
Title: President
Organization: Virginia Cardiovascular Specialists
Date: 01/11/2008
Comment:

Steve E. Phurrough, M.D., M.P.A.
Director, Coverage and Analysis Group
Office of Clinical Standards and Quality
Centers for Medicare & Medicaid Services
7500 Security Boulevard, Mail Stop C1-09-06
Baltimore,    More...



Commenter: Flees, Roger
Title: Sales Manager
Organization: Philips Healthcare
Date: 01/08/2008
Comment:

As an employee of a Medical Device Manufacturer
and a person currently enrolled in Medicare Part
A, I certainly would like to see the time-frame
extended for further research in CTA viablity. I
will be retiring in about 18 months a   More...



Commenter: Fleet, M.D., Stephen
Date: 01/04/2008
Comment:

The proposed NCD on Computed Tomographic
Angiography is overly restrictive and does not
reflect contemporary management of cardiac
patients. CT angiography is accurate and
effective at risk stratification, and there is
robust    More...



Commenter: Fleischer, Leslie
Date: 12/22/2007
Comment:

The proposed NCD does not fully reflect the current state of
evidence in support of CCTA in regard to symptomatic patients
with chronic stable angina at intermediate risk of CAD. For
example:
1. In patients who have h   More...



Commenter: Fogarty, Wanda
Date: 01/09/2008
Comment:

I think we are taking a backwards step in Medical
care by only approving two indications for CCTA.
This technology is a valuable tool for patients
with unequivical findings on stress tests and
without this tool, all pts would be c   More...



Commenter: Folli, Hugo
Organization: Saddleback Memorial Medical Center
Date: 01/09/2008
Comment:

I would like to include my opposition to the
proposed elimination and restriction of cardiac
CTA payments as currently envisioned by CMS.

This test offers a valuable diagnostic
alternative to more invasive procedures if
prop   More...



Commenter: follman, duane
Date: 01/10/2008
Comment:

Please do not cut Computed Tomographic
Angiograpy. It is a great tool for my patients
and is necessary for optimal management of
coronary artery disease.

It is imperative that it be reimbursed.

Please!

Duane Follm   More...



Commenter: Fontenot, Joey
Date: 12/21/2007
Comment:

In the clinical arena, the imnpact of coronary
CT is unarguably positive and important to the
patients most in need. The ability to identify
coronary artery disaese in a non-invasive manner
that reduces patient risk and ultimatley   More...



Commenter: Foster, MD,FACC, Jack
Title: Noninvasive Director
Organization: Cardiology Associates of North Mississippi
Date: 01/10/2008
Comment:

As a group of 17 cardiologist who practice in the
state (MS) with the highest mortality rate from
cardiovascular disease in the nation, and who also
serve a large Medicare population, we are
distressed to see CMS decision not to cover<   More...



Commenter: frabizzio, jennifer
Title: Radiologist
Organization: Radiology Group of Abington
Date: 01/10/2008
Comment:

The proposed medicare cuts for coronary CTA for
pts without symptomatic chest pain would have a
very negative affect on non invasive diagnosis of
coronary artery disease. This new technology in
time will prove to be as good or be   More...



Commenter: fram, daniel
Date: 01/12/2008
Comment:

The proposed NCD should be withdrawn. If it is
not withdrawn, substantial modifications should
be made to provide coverage for appropriate
indications and populations.
The proposed NCD does not adequately reflect the
current sta   More...



Commenter: Frey,MD, William
Title: MDRadiologist
Organization: Private practice
Date: 01/10/2008
Comment:

The proposed NCD DOES NOT REFLECT THE CURRENT
EVIDENCE IN SUPPORT OF CCTA AND SHOULD BE
WITHDRAWN!!!! CCTA IS NON INVASIVE AND WILL
SAVE MANY LIVES IN THE FUTURE.



Commenter: Gaffney, Dave
Date: 01/10/2008
Comment:

Cardiologists across the board agree (in private
if not public) that this technology is sound and
best practice for some patients when evaluated
objectively. It would be a shame to continue to
restrict this very valuable, less inva   More...



Commenter: Galinger, Holly
Title: pratice manager
Organization: Proscan Imaging
Date: 01/08/2008
Comment:

As a health care administrator I have personally
witnessed lives saved by use of this technology.
Heart disease remains the number one killer of
all Americans, so it is obvious that our current
standard of care will have no impact    More...



Commenter: Garcia, Mario
Date: 12/14/2007
Comment:

CTA is one of the most valuable non-invasive
tests that we have available in cardiovascular
medicine. Given the prevalence of CAD and the
limited accuracy of clinical criteria and other
existing non-invasive imaging modalities, a l   More...



Commenter: Garcia, MD, Israel
Title: M.D.
Organization: Cardiology Consultants of Johnson City, P.C.
Date: 01/10/2008
Comment:

The proposed NCD should be withdrawn. If it is
not withdrawn, substantial modifications should
be made to provide coverage for appropriate
indications and populations.

The proposed NCD does not adequately reflect the
curren   More...



Commenter: garnic, daniel
Title: md
Date: 01/08/2008
Comment:

the cta review by cms is burdened by
excessivesly ancient data considering ct systems
of less than 64 detectors. this at best skews
results and in point of fact suggests a limited
outcome. the cause of such error in methodology <   More...



Commenter: Gaschen, Fred
Date: 01/08/2008
Comment:

Come on guys; not a single one of you making this
decision would want a catheter threaded through
your veins to your heart so that you could have a
heart cath (30-40% are negative) instead of a non-
invasive CT that has a 99% negati   More...



Commenter: Gebow PhD, Dan
Title: Director
Organization: Number1Killer
Date: 01/12/2008
Comment:

We appreciate the opportunity to comment on the
proposed NCA for Computer Tomographic
Angiography (CAG-00385N).

This memo represents a petition that is signed by
2861 persons, of which 746 are physicians and
2115 are con   More...



Commenter: Gerber, Lowell
Title: Director of Cardiology Services
Organization: Down East Community Hospital
Date: 01/11/2008
Comment:

Several months ago I relocated from a large city
in Florida where I practiced at a tertiary care
hospital to a small critical access hospital in
rural Maine.

The nearest city is Bangor, 80 miles, and two
hours travel by car.   More...



Commenter: Ghavami, Richard
Title: M.D.
Organization: Radiology Associates of Clearwater
Date: 01/10/2008
Comment:
  • We disagree with CMS’ conclusions in the proposed Coronary Artery CTA (CCTA) coverage determination and believe that if implemented, the policy will be profoundly negative for Medicare beneficiaries by limiting their    More...


Commenter: Gillespie, MD,FACC,FASE,FANC, Robert
Date: 01/10/2008
Comment:

To Whom It May Concern:

The oulined changes to CTA reimbursement are troublesome and potentially does a great disservice to Medicare patients.  The use of CTA has decreased the need for invasive cath significantly    More...



Commenter: Girard, Steven
Title: Director of Echocardiography
Organization: Michigan Heart & Vascular Institute
Date: 01/11/2008
Comment:

I am a practicing cardiologist with subspecialty
training in diagnostic testing and noninvasive
imaging. The restrictive indications for coronary
CTA proposted in the NCD by CMS will not serve
the Medicare patient population well a   More...



Commenter: Glovier, MBA, Harold
Title: Practice Administrator
Organization: Cardiology Consultants of Johnson City, P.C.
Date: 01/10/2008
Comment:

The proposed NCD should be withdrawn. If it is
not withdrawn, substantial modifications should
be made to provide coverage for appropriate
indications and populations.

The proposed NCD does not adequately reflect the
curren   More...



Commenter: Gold, Jonathan
Date: 01/03/2008
Comment:

I have been involved in cardiac CTA for the past 2 years. I have
found it very usefull (and important tool) for medicare patients.

I have found the proposed usage for CTA to be confusing and
medically incorrect. The first usage (sym   More...



Commenter: Goodman, Gordon
Title: M.D.
Organization: Radiology Associates of Clearwater
Date: 01/10/2008
Comment:
  • We disagree with CMS’ conclusions in the proposed Coronary Artery CTA (CCTA) coverage determination and believe that if implemented, the policy will be profoundly negative for Medicare beneficiaries by limiting their    More...


Commenter: Gopal, MD,FACC, Deepika
Date: 01/12/2008
Comment:

1.      My license number is TX L2285. I am a board certified cardiologist. This proposed Medicare position re Cardiac CTA is the single worst decision re the care of the American public I have seen in ye   More...



Commenter: Goraya, Tauqir
Title: Director Nuclaer Cardiology and Cardiovascular CT
Organization: Michigan Heart
Date: 01/11/2008
Comment:

I. Does CCTA have the ability to diagnose
CAD as well as Invasive Coronary angiography
(ICAG)?
I believe that the evidence is definitely there
to answer this question in the affirmative.
Reported 64-slice CT meta-analysis (pati   More...



Commenter: Gorra, David
Title: COO
Organization: New York Heart Center
Date: 01/11/2008
Comment:



RE: Proposed Decision Memo for Computed
Tomographic Angiography (CAG-00385N)


We represent the New York Heart Center (NYHC),
which provides Cardiology services to the greater
Central New York area, including Syracuse,   More...



Commenter: Goss, Victoria
Title: Nuclear Medicine / Ultrasound Supervisor
Organization: CHRISTUS HOSPITAL St. Elizabeth
Date: 01/10/2008
Comment:

As for CTA / NM stress testing and other
procedures that are over utilized CMS needs to
look at the free standing physician offices that
are removing these from the hospital enviroment.
I have been in health care 30 plus years and    More...



Commenter: Gotway, Mike
Date: 01/10/2008
Comment:

Proposed National Coverage Determination for
Coronary CT Angiography (CAG-00385N)

I am writing in response to the proposed
national coverage determination (NCD) for
coronary CT angiography (CCTA) recently
publicized by Medic   More...



Commenter: goudy, mildred
Organization: North Ohio Heart Center
Date: 01/11/2008
Comment:

I'm very suprised that the availablity of the
Computed Tomographic Angiography is being
considered decreased access to medicare
patients. I deal with these patients on a daily
basis, The patients are so relieved when they
fin   More...



Commenter: Grace, Jim
Date: 01/11/2008
Comment:

Dear Sir or Madam,

I am writing in regard to the recent situation
with medicare not wanting to re-emburse for CTA
studies.
It really seems to me that medicare is not
looking at the big picture on this matter.
The idea of b   More...



Commenter: Grad, Michael
Date: 01/08/2008
Comment:

CTA provides excellent positive and (more
importantly) negative predictive value
concerning CAD. This technology allows patients
to undergo evaluation of coronary anatomy non-
invasively, and over time, allows savings to the
pa   More...



Commenter: Grist, Thomas
Date: 01/10/2008
Comment:

We believe that it will be Medicare
beneficiaries who will suffer if the proposed
National Coverage Determination (NCD) is put in
place for CCTA (Computed Coronary Tomography
Angiography),



As proposed, the NCD sever   More...



Commenter: Grizzard, John
Title: Asst. Professor, Non-invasive Cardiovascular imagi
Date: 01/10/2008
Comment:

Coronary CT anngiography has already been shown
to shorten length of stay in the ED for chest
pain patients, with the same or better accuracy
as nuclear imaging. In addition, knowing that up
to 1/3rd of invasive catheterizations s   More...



Commenter: Grygo, Ann
Title: Clinical Liaison
Organization: Cardiovascular Associates
Date: 01/10/2008
Comment:


RE: Proposed Decision Memo for Computed
Tomographic Angiography (CAG-00385N)

I represent CARDIOVASCULAR ASSOCIATES, SC, which
provides Cardiology services to the greater Elk
Grove Village/Hoffman Estates   More...



Commenter: Gurinsky, Dr. Joseph S
Title: Radiologist
Organization: Lake Medical Imaging
Date: 01/10/2008
Comment:

I oppose the proposed national coverage policy
for coronary CTA for the following reasons:

• We disagree with CMS’ conclusions in the
proposed Coronary Artery CTA (CCTA) coverage
determination and believe that if implemented,    More...



Commenter: Gustafson, MD, Gary
Title: Director, Radiation Oncology
Date: 01/11/2008
Comment:

This proposed change is far to limited. I
believe many people will be denied a very
beneficial non-invasive procedure.
I believe this goes against the practice allowed
under the current LCD guideline.
I have beed a patient that   More...



Commenter: Guthmann, Anita
Title: Radiology Nurse Manager
Date: 01/11/2008
Comment:

Coronary CTA is a valid and appropriate exam in
specific patient populations, and reimbursement
in these situations should not be curtailed.
However, I do recognize the potential for over
utilization as most every Cardiac office h   More...



Commenter: Habib, Holli
Date: 01/10/2008
Comment:

RE: Proposed Decision Memo for Computed
Tomographic Angiography (CAG-00385N)



I represent CARDIOVASCULAR ASSOCIATES, SC, which
provides Cardiology services to the greater Elk
Grove Village/Hoffman Estates, IL area. W   More...



Commenter: Hale, MD, DAvid
Title: Chairman Dept. of Cardiology
Organization: alexian Brothers Medical Center
Date: 01/09/2008
Comment:

To: Center for Medicare and Medicaid Services
(CMS)

Re: National Coverage Determination (NCD) for
Cardiac Computerized Tomographic

Angiography (CCTA)
As Chair of the Department of Cardiology at
Alexian    More...



Commenter: Halleran, William
Title: M.D.
Organization: Radiology Associates of Clearwater
Date: 01/10/2008
Comment:
  • We disagree with CMS’ conclusions in the proposed Coronary Artery CTA (CCTA) coverage determination and believe that if implemented, the policy will be profoundly negative for Medicare beneficiaries by limiting their    More...


Commenter: Hamati, MD, Fawwaz
Title: Secretary
Organization: Cardiology Consultants of Johnson City, P.C.
Date: 01/10/2008
Comment:

The proposed NCD should be withdrawn. If it is
not withdrawn, substantial modifications should
be made to provide coverage for appropriate
indications and populations.

The proposed NCD does not adequately reflect the
curren   More...



Commenter: Hamilton, Lori
Title: Financial Manager
Organization: Radiology Associates of Central Florida, P.L.
Date: 01/10/2008
Comment:

I disagree with CMS’conclusions in the proposed
Coronary Artery CTA (CCTA) coverage determination
and believe that if implemented, the policy will
be profoundly negative for Medicare beneficiaries
by limiting their access to CCTA f   More...



Commenter: Hamlin, John
Title: Radiologist
Organization: University of Oklahoma Health Sciences Center and INTEGRIS Clinton Regional Hospital
Date: 01/11/2008
Comment:

From John Hamlin, MD

I am a radiologist who was recently trained to
interpret Cardiac CTA. During the learning
process I viewed cases of patients that had both
conventional coronary artery angiography and a
CTA within a shor   More...



Commenter: Hanchett, Edward
Date: 01/08/2008
Comment:

This proposal will severely limit the access and
application of a truly innovative technologic
advancement in the study of coronary artery
disease. Several research studies have already
proven the value of the Coronary CTA imaging   More...



Commenter: Hanson, Kirsten
Title: Physician
Date: 01/08/2008
Comment:

I am outraged at the short sited approach to the
use of CT Coronary Angiogrpahy as as proposed by
CMS. These restrictions completely limit the
ability to be proactive and diagnose coronary
artery disease in a quick efficient and n   More...



Commenter: Harding, John
Date: 01/11/2008
Comment:

Failure to provide coverage for coronary CT
arteriography (CCTA) is a disservice to patients
and a potential failure of CMS to control
spending on far more expensive and potentially
risky diagnostic catheter angiography.

CC   More...



Commenter: Harper, Kathleen
Organization: Cardiology Physicians
Date: 01/12/2008
Comment:

CTA is a valuable tool in cardiac diagnosis and
the only tool for early screening for the
severity and extent of coronary athersclerosis
without a catheterization and the costs
thereof.If the CTA is neg this should then
disallo   More...



Commenter: Harris, Brad
Title: Director of Imaging
Organization: ARMC
Date: 01/11/2008
Comment:

I am writing in regards to the proposed national
coverage determination which could overturn
current medicare local coverage determinations
for cardiac cta. Cardiac CTA is a viable exam to
determine coronary artery disease. There a   More...



Commenter: Harrison, Linda
Date: 01/08/2008
Comment:

The proposal to limit payment on coronary CTA is
quite concerning. Coronary CTA has the potential
to significantly reduce the number of negative
stress tests and coronary catheterizations.
Negative coronary caths are a particular p   More...



Commenter: Harrison, Timothy
Organization: just a concerned citizen
Date: 01/09/2008
Comment:

We need the availablity of "computed tomographic
angiography" in our rural hospital. We have many
many residents who are in their 70's and beyond
in this area. Plus many people are retiring to
this remote area of Maine. To deprive   More...



Commenter: Harrison MD, Eric
Title: President
Organization: Cardiac Care Critique Inc.
Date: 01/10/2008
Comment:

Dear Sirs, I have authored the DVD set "Practical
Interpretation of Computed Coronary Tomography on
the Workstation" and have had a great deal of
experience in cardiac ct. I have performed more
than 14,000 cardiac catheterizations in m   More...



Commenter: Hart, Melanie
Title: Supervisor/Executive Assistant
Organization: Cardiology Consultants of Johnson City, P.C.
Date: 01/10/2008
Comment:

The proposed NCD should be withdrawn. If it is
not withdrawn, substantial modifications should
be made to provide coverage for appropriate
indications and populations.

The proposed NCD does not adequately reflect the
curren   More...



Commenter: Hartman, Corey
Title: Chief CT Technologist
Organization: Penn State Milton S. Hershey Medical Center
Date: 01/10/2008
Comment:

The benefits of Coronary CTA include speed, very
low risk, and an amazing amount of information.
With Coronary CTA, we can get an entire roadmap
of the arteries. It also allows us to see into
the walls of the blood vessels and se   More...



Commenter: Haseman, Michael
Date: 01/08/2008
Comment:

Limiting a CMS beneficiary's access to coronary
CT scans makes no sense to me. CTA's have an
extremely high negative predictive value,
consequently, the use of this test often leads to
avoidance of much more expensive, and invas   More...



Commenter: Heagy, Terry
Title: Clinical Business Relations Manager, CT Products
Organization: MEDRAD
Date: 01/11/2008
Comment:

This response is in reference to the NCA/CAL Computed Tomographic Angiography position posted by CMS. On behalf of MEDRAD inc. I would like to express our concern with the position that CMS has taken relative to CT Angiography.

We have r   More...



Commenter: Hecht, Harvey
Title: President Emeritus and current Treasurer
Organization: Society of Atherosclerosis Imaging and Prevention
Date: 01/06/2008
Comment:

The impending CMS CTA noncoverage determination
represents a major step backwards in patient
care. The rapidly expanding database has made the
following crystal clear:

1. CTA is more sensitive, specific and
accurate than str   More...



Commenter: Heinke, Lowell
Title: M.D.
Organization: Radiology Associates of Clearwater
Date: 01/10/2008
Comment:
  • We disagree with CMS’ conclusions in the proposed Coronary Artery CTA (CCTA) coverage determination and believe that if implemented, the policy will be profoundly negative for Medicare beneficiaries by limiting their    More...


Commenter: Held, Richard
Date: 01/10/2008
Comment:

To whom it may concern:
The conclusions cannot possibly be correct, or
based on thoughtful review of evidence.
Furthermore, it is contradictory to previous
decisions. I find it outrageous that you would
deny this level of care    More...



Commenter: Held, Dr. Richard K.
Title: Radiologist
Organization: Lake Medical Imaging
Date: 01/10/2008
Comment:

I oppose the proposed national coverage policy
for coronary CTA for the following reasons:

• We disagree with CMS’ conclusions in the
proposed Coronary Artery CTA (CCTA) coverage
determination and believe that if implemented,    More...



Commenter: Hellman, Joel
Title: Cardiologist
Date: 01/10/2008
Comment:

CTA of the coronaries is safer and cheaper than
coronary angiography. As a practicing
interventional cardiologist I have had patients
who were spared the risk and expense of cardiac
catheterization by this invaluable technology.    More...



Commenter: Hennen, Ryan
Date: 01/08/2008
Comment:

Hello -

I think this NCD is proposterous. I have seen
the test save countless dollars in preventing
unneccessary diagnostic caths. Plus, for the
patient population that does need a cath to
follow the CTA, the cardiologist    More...



Commenter: Herman, Jeffrey
Title: Physician/Radiologist
Organization: Diagnostic Imaging Centers, P.A.
Date: 01/08/2008
Comment:

The proposed restrictions on outpatient coronary
artery CTA reimbursement are absolutely
baseless. This appears to be blatant pandering
to the cardiology lobby. If anything, coronary
artery CTA may be performed more efficiently a   More...



Commenter: Hermanson, Karen
Date: 01/10/2008
Comment:

Those of us in the health care industry are
demonstrating that CTA adds clinical value to
patient management while bringing cost savings to
the healthcare system. Peer–reviewed studies and
multi-center trials with tens of thousands   More...



Commenter: Hill, DO, Gregory
Title: Commentary on CMS proposed NCD for Cardiac CTA
Organization: Cardiology of Tulsa
Date: 01/10/2008
Comment:

Commentary on CMS proposed NCD for Cardiac CTA
As a physician who has been intimately involved
in cardiac CTA over the last four years, I think
it is very unfortunate that CMS has approached
national coverage of this highly importan   More...



Commenter: Hiremagalur, MD, Shobha
Title: Director of CT
Organization: Cardiology Consultants of Johnson City, P.C.
Date: 01/10/2008
Comment:

The proposed NCD should be withdrawn. If it is
not withdrawn, substantial modifications should
be made to provide coverage for appropriate
indications and populations.

The proposed NCD does not adequately reflect the
curren   More...



Commenter: Hoffberg, Neal
Date: 01/09/2008
Comment:

CVCT is one of the most important advancements
in the detection and management of coronary
artery disease. It is fast, efficient and very
convenient for the patient. CVCT has the
ability to transform the cardiology office of
   More...



Commenter: Hoffman, MD, Donald
Title: President
Organization: Cardiopulmonary Associates of the Treasure Coast, PA
Date: 01/11/2008
Comment:

We have found Cardiac CTA with 64 slice CT capability has significantly
improved our ability to diagnose and treat coronary and cardiac disease in
our population, an elderly basically Medicare population.
1. It offers a less invasive an   More...



Commenter: Hollenbacher, Howard
Title: RT (R)(CT)
Date: 01/10/2008
Comment:

I am disappointed at a time when there is a push
to decrease the cost of health care, that our
country would would pass any measures that would
make an exam that is not only less expensive but
SAFER and much less invasive than the    More...



Commenter: Hollingsworth, Angelica
Title: Team Leader Coding and Billing
Organization: CMI
Date: 01/10/2008
Comment:

RE: Proposed Decision Memo for Computed
Tomographic Angiography (CAG-00385N)

I represent Cardiovascular Management of Illinois
which provides Cardiology services to the greater
Chicagoland area. We have 29 physicians and serve <   More...



Commenter: Honeycutt, Ann
Title: President
Organization: Cardiology Advocacy Alliance
Date: 01/10/2008
Comment:

Steve E. Phurrough, M.D., M.P.A.
Director, Coverage and Analysis Group
Office of Clinical Standards and Quality
Centers for Medicare & Medicaid Services
7500 Security Boulevard, Mail Stop C1-09-06
Baltimore, MD 21244-1850

Re:   More...



Commenter: Hopkins, Christie
Date: 01/12/2008
Comment:

Coronary CT angiography is the most important
advance in Cardiology in my lifetime. Your
policy needs careful review by thoughtful and
knowledgeable people. You are condemning
thousands of Americans to premature and
unnecessa   More...



Commenter: Houston, Dr. C. Steve
Title: Radiologist
Organization: Lake Medical Imaging
Date: 01/10/2008
Comment:

I oppose the proposed national coverage policy
for coronary CTA for the following reasons:

• We disagree with CMS’ conclusions in the
proposed Coronary Artery CTA (CCTA) coverage
determination and believe that if implemented,    More...



Commenter: Howard, L.K.
Date: 01/10/2008
Comment:

The proposed NCD is totally unreasonable. During
one year of use, many of my patients have avoided
invasive cardiac catheterization because of
CTA.There are many situations where CTA gives
information otherwise unobtainable eg. Con   More...



Commenter: Howard, Robert
Title: M.D.
Organization: Radiology Associates of Clearwater
Date: 01/10/2008
Comment:
  • We disagree with CMS’ conclusions in the proposed Coronary Artery CTA (CCTA) coverage determination and believe that if implemented, the policy will be profoundly negative for Medicare beneficiaries by limiting their    More...


Commenter: Howard, Teresa
Title: M.D.
Organization: Radiology Associates of Clearwater
Date: 01/10/2008
Comment:
  • We disagree with CMS’ conclusions in the proposed Coronary Artery CTA (CCTA) coverage determination and believe that if implemented, the policy will be profoundly negative for Medicare beneficiaries by limiting their    More...


Commenter: Huntowski, Patricia
Date: 01/10/2008
Comment:

I am a CatScan Technologist, and I am involved in
Cardiac CT. Just about every patient that comes
through our department says" I am so glad that I
can have this test, I didn't want to have a
Cardiac Cath"!!!!! Lets get it together   More...



Commenter: Isaacson, Thomas
Title: Medical Director
Date: 01/06/2008
Comment:

It seems to me that there has not been full examination of this
proposal will have on the Medicare beneficiary. If the driver for
this proposal is the fear of misuse of a technology, there is no
credible published evidence to substanti   More...



Commenter: jackson, md, mark
Title: MD, cardiologist
Date: 01/09/2008
Comment:

We have been doing CTA in our cardiology practice
for over a year. This has substantially improved
patient cost and improved patient safety by
reducing cardiac catheterizations for false
positive stress tests. To eliminate CTA and    More...



Commenter: Jacobson, Dr. Mark
Title: Radiologist
Organization: Lake Medical Imaging
Date: 01/10/2008
Comment:

I oppose the proposed national coverage policy
for coronary CTA for the following reasons:

• We disagree with CMS’ conclusions in the
proposed Coronary Artery CTA (CCTA) coverage
determination and believe that if implemented,    More...



Commenter: Jaikishen,MD, Jay
Date: 01/12/2008
Comment:

After a nuclear stress test was abnormal, I have numerous cases who underwent Cardiac CTA which did not show significant obstructive cardiac diease. These patients did not undergo invasive cardiac catherterization with huge cost savings for medica   More...



Commenter: JAMBHEKAR, KEDAR
Title: ASSISTANT PROFESSOR OF RADIOLOGY
Organization: UAMS
Date: 01/09/2008
Comment:

We have been performing cardiac CT for over 2
years, first with a 16 slice and recently with a
64 slice scanner.Though it is true that there is
a substantial radiation dose associated with the
cardiac CT, it is equally true that th   More...



Commenter: Jara, Cesar
Title: Interventional Cardiologist
Organization: Osler Medical
Date: 01/11/2008
Comment:

I understand the concern of CMS about
inappropriate use of cardiac/coronary CTA. I
will advise to use the medical society
guidelines (appropriatness criteria), rather
than this drastic decision that will affect
patient care. Ca   More...



Commenter: Jehle, Eve
Title: M.D.
Organization: Radiology Associates of Clearwater
Date: 01/10/2008
Comment:
  • We disagree with CMS’ conclusions in the proposed Coronary Artery CTA (CCTA) coverage determination and believe that if implemented, the policy will be profoundly negative for Medicare beneficiaries by limiting their    More...


Commenter: Joffe, MD, C David
Title: Senior Physician and Medical Director
Organization: Dayton Heart Center and Hospital
Date: 01/12/2008
Comment:

I am a triple boarded interventional cardiologist
who has worked with and embrased the clinical
utility of coronary CTA . I have worked with the
tool for the last 2 years. The proposed non-
coverage for any patients except those w   More...



Commenter: Johnson, Douglas
Date: 01/12/2008
Comment:

It would be a tremendous blow to cardiac care if
the proposed limitations were passed. In our
hospital, we have seen a great impact both in
clinical management and overall cost savings
with the availability of Cardiac CTA.



Commenter: JOhnson, Kevin
Title: CFO
Organization: Midtown Imaging, LLC
Date: 01/08/2008
Comment:

The advent of 64-slice CT and Coronary CTA has
just begun to gain traction and in the imaging
and specifically the outpatient imaging sector.
The benefits are only beginning to be understood
and fully embraced by the medical commu   More...



Commenter: johnson, stephen
Title: Chief, Interventional Radiology
Organization: University colorado
Date: 01/10/2008
Comment:

Myocardial Infarction remains the #1 cause of death in this country.
The population is aging and heart disease will continue killing
Americans unless an effective non-invasive test can accurately
evaluate patients at risk prior to MI.    More...



Commenter: Joliff, John
Organization: Cardiology Consultants of Topeka
Date: 01/10/2008
Comment:

This proposal is unreasonable and should be
withdrawn. It doesn't reflect the importance of
this technology to the medicare population. In
our initial exposure to this technology, it is
clear that many patients have made signific   More...



Commenter: Jones, Nancy
Title: Administrative Assistant
Organization: Lake Medical Imaging
Date: 01/10/2008
Comment:

I oppose the proposed national coverage policy
for coronary CTA for the following reasons:

• We disagree with CMS’ conclusions in the
proposed Coronary Artery CTA (CCTA) coverage
determination and believe that if implemented,    More...



Commenter: jordan, wendy
Date: 01/10/2008
Comment:

· The proposed NCD will limit access to
CCTA, which is a very useful, non-invasive, safe
method of coronary interrogation, in favor of
more costly, more invasive, and more risky
invasive coronary artery catheterization. CC   More...



Commenter: Justman, Richard
Title: National Medical Director
Organization: UnitedHealthcare
Date: 01/10/2008
Comment:

UnitedHealthcare comments:
Our comments are as follows:
1. We believe that clinical evidence supports
the use of coronary computed tomographic
angiography using 64-slice or greater technology
for the assessment of patients with    More...



Commenter: KACERE, RICHARD
Date: 01/10/2008
Comment:

The proposed NCD should be withdrawn. If it is not withdrawn,
substantial modifications should be made to provide
coverage for appropriate indications and populations.
• The proposed NCD does not adequately reflect the current
state    More...



Commenter: Kadiyala, Madhavi
Date: 01/12/2008
Comment:

Cardiac CT angiography is an invaluable tool for everyone. While it
is prudent to scrutinize a new technology, it will be a great
disservice to the country to take this stance. Identification of
coronary artery disease before it has c   More...



Commenter: Kahn, Daniel
Title: Professor, Radiology and Chief Nuclear Medicine VA
Organization: University of Iowa Hospital and Clinics and Iowa City VAMC
Date: 01/07/2008
Comment:

I am an imaging specialist (Internal Medicine and Nuclear Medicine trained) with nearly 20 years experience interpreting noninvasive cardiac exams. I have been overseeing and interpreting CTA of coronary arteries for over 1.5 years.

It i   More...



Commenter: Kainz, Dr. George E.
Title: Radiologist
Organization: Lake Medical Imaging
Date: 01/10/2008
Comment:

I oppose the proposed national coverage policy
for coronary CTA for the following reasons:

• We disagree with CMS’ conclusions in the
proposed Coronary Artery CTA (CCTA) coverage
determination and believe that if implemented,    More...



Commenter: Kang, Ahe-Jin
Title: Charge entry Coding & Billing
Organization: CMI
Date: 01/11/2008
Comment:


RE: Proposed Decision Memo for Computed
Tomographic Angiography (CAG-00385N)

I represent Cardiovascular Management of Illinois
which provides Cardiology services to the greater
Chicagoland area. We have 29 physicians and ser   More...



Commenter: Katrensky jr. RT(r), John S.
Date: 01/08/2008
Comment:

I urge you to reconsider your proposed NCD
limiting payments for Cardiac CT Angiography. In
two and a half years of scanning, our site in NJ
has scanned almost two thousand patients with
this modality (all of them a medical necessi   More...



Commenter: Kazerooni, MD, Ella
Title: Professor and Director of Cardiothoracic Radiology
Organization: University of Michigan Medical Center
Date: 01/10/2008
Comment:


January 8, 2008

Steve E. Phurrough, MD, MPA
Director, Coverage and Analysis Group
Centers for Medicare and Medicaid Services
Mailstop C1-09-06
7500 Security Blvd.
Baltimore, MD 21244-1850

Re: Proposed National Cove   More...



Commenter: Keller, Dr. Cathrine
Title: Radiologist
Organization: Lake Medical Imaging
Date: 01/10/2008
Comment:

I oppose the proposed national coverage policy
for coronary CTA for the following reasons:

• We disagree with CMS’ conclusions in the
proposed Coronary Artery CTA (CCTA) coverage
determination and believe that if implemented,    More...



Commenter: Keller, Mark
Title: Director of Imaging
Organization: St. Paul Heart Clinic
Date: 01/10/2008
Comment:

I ask that CMS suspend its proposed NCD for at
least 2 years regarding Coronary CTA and ask that
CMS consider the 25 studies that were published
in 2007 regarding cornoary CTA that were left out
of the agency's assessment.



Commenter: Kelley, Michael
Date: 01/07/2008
Comment:

This proposed legislation is a reversal of state
Medicare carriers' decision as well as most of
the private insurers' decision to cover Coronary
CTA. The decision is short-sighted and is based
on biased information and an incom   More...



Commenter: Kent, Steven
Title: Cardiac CTA program
Organization: Moore Regional Hospital Pinehurst NC
Date: 01/06/2008
Comment:

As a cardiologist and director of a hospital
based Cardiac CTA program, I have tremendous
respect for both the benefits and limitations of
this evolving procedure. The National Coverage
Analysis as written is inadequate with regar   More...



Commenter: Kermisch, Josh
Title: Director of Business Development
Organization: Oregon Imaging Centers
Date: 01/09/2008
Comment:

CCTA may be a valuable tool for ruling out
coronary disease in both acute care and non-acute
care settings. Changing coverage determination
now will limit Medicare patient access to this
valuable test and encourage more expensive and<   More...



Commenter: Kern, Joshua
Title: Physician
Date: 01/09/2008
Comment:

I am a radiologist who has been involved in cardiac CTA for the past four years and have witnessed this technology evolve into the most powerful non invasive tool for evaluating the coronary arteries. I think that it is very unfortunate that CMS h   More...



Commenter: Khan, Mohammed
Date: 01/10/2008
Comment:

I represent CARDIOVASCULAR ASSOCIATES, SC, which
provides Cardiology services to the greater Elk
Grove Village/Hoffman Estates, IL area. We have
19 physicians, 85 employees and serve
approximately 16,000 patients annually.
CARD   More...



Commenter: khan, Muhammad
Title: M.D.
Organization: Cardiac Center of Texas
Date: 01/12/2008
Comment:

I have 64 slice cardiac CTA in my office for last 1 year. It is eye opening experience. It is win- win scenario for patients,physicians and payor. It is very accurate and highly specific. We have reduced unnecessary invasive procedure more than 50   More...



Commenter: Khan, MD, Ahmed
Title: Interventional Cardiologist / Electrophysiologist
Organization: Cardiology Consultants of Johnson City, P.C.
Date: 01/10/2008
Comment:

The proposed NCD should be withdrawn. If it is
not withdrawn, substantial modifications should
be made to provide coverage for appropriate
indications and populations.

The proposed NCD does not adequately reflect the
curren   More...



Commenter: Kliewer, Mark
Date: 01/09/2008
Comment:

We believe that it will be Medicare
beneficiaries who will suffer if the proposed
National Coverage Determination (NCD) is put in
place for CCTA (Computed Coronary Tomography
Angiography),



As proposed, the NCD sever   More...



Commenter: Koch, MD, Stephen
Title: President
Organization: Stephen Koch, MD, PC
Date: 01/08/2008
Comment:

I will let the many other physicians comment on
the actual facts and data acquired from clinical
studies performed over the last few years
concerning the clinical value and scientific
relevancy of cardiac/coronary CTA. I want to
co   More...



Commenter: kogan, nephtali
Date: 01/10/2008
Comment:

RE: Proposed Decision Memo for Computed
Tomographic Angiography (CAG-00385N)



I represent CARDIOVASCULAR ASSOCIATES, SC, which
provides Cardiology services to the greater Elk
Grove Village/Hoffman Estates, IL area. W   More...



Commenter: Kogan, M.D., James
Title: Radilogist
Organization: Grapevine Radiology Associates
Date: 01/11/2008
Comment:

Coronary CTA is a very sensitive and specific
test and should be reimbursed by Medicare. It
has saved several pt's lifes at our hospital over
the past year. It's cheaper and sometimes more
accurate than the more expensive and i   More...



Commenter: Konieczny, nancy
Title: Charge Entry Coding & Billing Specialist
Organization: CMI
Date: 01/11/2008
Comment:



RE: Proposed Decision Memo for Computed
Tomographic Angiography (CAG-00385N)

I represent Cardiovascular Management of Illinois
which provides Cardiology services to the greater
Chicagoland area. We have 29 physicians and   More...



Commenter: Kop, Sheldon
Organization: Great Basin Imaging
Date: 01/08/2008
Comment:

January 8, 2008


Dear Centers for Medicare and Medicaid Services:

I strongly urge the Centers for Medicare and
Medicaid Services (CMS) to reconsider its
proposal and National Coverage Decision (NCD)
regarding coronary    More...



Commenter: kramer, neil
Date: 01/11/2008
Comment:

CCTA can save patient morbidity and mortality by
replacing cath with a non-invasive technique.
The NPV of CCTA is unequalled by any other test.
Recent 64 slice and better literature confims
this and supports outstanding PPV as we   More...



Commenter: Kramer, David
Date: 01/12/2008
Comment:

I favor Medicare coverage for Coronary CTA
(CCTA.CCTA can save patient morbidity and
mortality by replacing cath with a non-invasive
technique. The NPV of CCTA is unequalled by any
other test. Recent 64 slice and better
litera   More...



Commenter: Kraus, Barry
Title: M.D.
Organization: Radiology Associates of Clearwater
Date: 01/10/2008
Comment:
  • We disagree with CMS’ conclusions in the proposed Coronary Artery CTA (CCTA) coverage determination and believe that if implemented, the policy will be profoundly negative for Medicare beneficiaries by limiting their    More...


Commenter: Krauss, MD, Daniel
Title: MD
Organization: Illinois Heart & Vascular
Date: 01/10/2008
Comment:

RE: Proposed Decision Memo for Computed
Tomographic Angiography (CAG-00385N)

We represent Illinois Heart and Vascular which
provides Cardiology services to the greater
Chicago land area. We have 27 physicians, 92
employees and s   More...



Commenter: Kreider, Wendy
Date: 01/11/2008
Comment:

The recent Preliminary NCD for Cardiac CTA is
short sighted and does not consider the numerous
studies done providing substantial argument in
favor of cardiac CTA for low risk chest pain
patients. Cardiac CTA has an extremely high   More...



Commenter: Krop, Daniel
Title: M.D.
Organization: Radiology Associates of Clearwater
Date: 01/10/2008
Comment:
  • We disagree with CMS’ conclusions in the proposed Coronary Artery CTA (CCTA) coverage determination and believe that if implemented, the policy will be profoundly negative for Medicare beneficiaries by limiting their    More...


Commenter: Kross, MD FACC, Dean
Date: 12/27/2007
Comment:

I compliment you on your extensive report, but with regret, I must tell you that it is naive and uninformed.  As a clinical cardiologist who has become adept at analyzing coronary ct angiograms (without compensation) and man   More...



Commenter: Kruger, David
Title: CEO
Organization: Thoracic and Cardiovascular Institute, P.C.
Date: 01/10/2008
Comment:

RE: Proposed Decision Memo for Computed
Tomographic Angiography (CAG-00385N)

I am the CEO of a 22 physician cardiology
practice in Lansing, MI. On behalf of the
physicians, staff and patients at Thoracic &
Cardiovascular In   More...



Commenter: Krupa, Robert
Title: M.D.
Organization: Radiology Associates of Clearwater
Date: 01/10/2008
Comment:
  • We disagree with CMS’ conclusions in the proposed Coronary Artery CTA (CCTA) coverage determination and believe that if implemented, the policy will be profoundly negative for Medicare beneficiaries by limiting their    More...


Commenter: Lacomis, Joan
Title: MD
Organization: University of Pittsburgh
Date: 01/11/2008
Comment:

The proposed NCD should be withdrawn. If it is
not withdrawn, substantial modifications should
be made to provide coverage for appropriate
indications and populations.
The proposed NCD does not adequately reflect the
current sta   More...



Commenter: Lain-Guevara, Maryjo
Title: Charge Entry
Organization: CMI
Date: 01/11/2008
Comment:

RE: Proposed Decision Memo for Computed
Tomographic Angiography (CAG-00385N)

I represent Cardiovascular Management of Illinois
which provides Cardiology services to the greater
Chicagoland area. We have 19 physicians and serve <   More...



Commenter: Lam, James
Title: Cardiologist
Organization: Cardiovascular Institute of the South
Date: 01/11/2008
Comment:

I practice in a small rural town in southern
Louisiana. We do not have an operative cath lab.
The cardiac evaluation have been significantly
helped with the availability of the MSCT in our
local hospital. If this is no longer avail   More...



Commenter: lamptey, al
Date: 01/11/2008
Comment:

current state of evidence in support of CCTA in
regard to symptomatic patients with chronic
stable angina at intermediate risk of CAD.I urge
the officials at CMS to speak to all the medicare
patients whose lives have been saved or    More...



Commenter: Landis, David
Organization: Great Basin Imaging
Date: 01/08/2008
Comment:

January 8, 2008


Dear Centers for Medicare and Medicaid Services:

I strongly urge the Centers for Medicare and
Medicaid Services (CMS) to reconsider its
proposal and National Coverage Decision (NCD)
regarding coronary    More...



Commenter: Lane, Judy
Date: 12/31/2007
Comment:

I have been involved in Coronary CT Angiography
for 6 years. I have seen many remarkable
diagnosis that have gone on to be corrected. I
have cared for children and adults of all ages.
Had the patient not had CTA the diagnosis woul   More...



Commenter: Langer, Michael
Title: Cardiologist
Organization: North Ohio Heart Institute
Date: 01/10/2008
Comment:

To whom it may concern,
I want to express my sincere disappointment with
the recent CMS proposal regarding CCTA. This
policy will affect the availablity of this
extremely valuable technology for our patients. I
am a practicing c   More...



Commenter: Larson, Elsie
Organization: UMM - Retired
Date: 01/10/2008
Comment:

This would benefit many people in the Machias area;
it definitely would decrease the number of miles
that people would need to travel to get to Bangor.

I'm pleased that DECH is looking to include this
service at the local hospital   More...



Commenter: LAUREL, ALONZO
Date: 01/11/2008
Comment:

I am writing to express my concern over a
National Coverage Decision (NCD) proposal that
CMS is making that will limit an important and
potentially lifesaving test to Medicare
beneficiaries.

ALONZO LAUREL



Commenter: Laurie, Karen
Date: 01/09/2008
Comment:

It is disappointing to think that the brakes could be appied to this much needed tool used in fighting cardiovacular disease. As a women I feel Cardiac CTA provied an oppotunity to diagnos disease when our symptoms do not always fit into the stand   More...



Commenter: Lauro, Bridget
Organization: Rocky Mountain Radiology, PC
Date: 01/11/2008
Comment:

Centers for Medicare & Medicaid Services,

Department of Health and Human Services,

Attention: Joseph Chin, M.D. and JoAnna Baldwin,
M.S.

P.O. Box 8014

Baltimore, MD 21244-8018



Re: Medicare Program; P   More...



Commenter: Leal, John
Date: 12/18/2007
Comment:

How can you ignore the data that shows we find
the patients that are missed by ALL other
modality and testing. Seems like another
example of putting your head in the sand and
hope it goes away! It''s time to pull your head
   More...



Commenter: Leigh, Lawrence
Date: 01/12/2008
Comment:

I am a board certified interventional
radiologist. This proposed Medicare position re
Cardiac CTA is a really awful decision based
simply on perceived utilization rather than the
good it can do in saving American lives.
There is    More...



Commenter: leitch, robert
Organization: lancaster general hospital
Date: 01/10/2008
Comment:

Cardiac CT is one of most promising patient care
issues in a long time. I find it inexcuseable
that such drastic action has been taken to kill
a technology that would decrease admissions,
decrease patient risk, and decrease costs    More...



Commenter: Lenis, Michael
Title: Cardiologist
Organization: Parkside Cardiology
Date: 12/23/2007
Comment:

The proposed NCD is particularly worrisome and
does not fully reflect the current state of
evidence in support of CCTA. The requirements CMS
has established to obtain coverage for CCTA will
have a very negative impact on Medicare <   More...



Commenter: Lenkinski, Robert
Title: Professor, Vice Chair
Organization: Beth Israel Deaconess Medical Center/Harvard Medical School
Date: 01/09/2008
Comment:

In the era of evidence-based medicine, there have
been very few modalities that have shown as much
data about the diagnostic accuracy and effect on
outcomes as coronary CTA. The scientific data
provides overwhelming support for the use   More...



Commenter: Lepor, Norman
Title: Associate CLinical Professor of Medicine
Organization: UCLA School of Medicine/Cedars-Sinai Medical Ctr
Date: 01/03/2008
Comment:

Cardiac CTA has had lifesaving implications in my
practice while at the same time allowing me to
practice in a more cost-effective fashion.
Cardiac CT has been able to allow for the rapid
and accurate diagnosis of chest apin syndro   More...



Commenter: Lerman, Robert
Title: Physician
Organization: Los Angeles Cardiology Associates
Date: 01/10/2008
Comment:

Patient care will be adversely affected if the
proposed restrictions and rules for cardiac CTA
are adopted.

1. CMS has not examined the full impact
this proposal will have on the Medicare
beneficiary. If the driver f   More...



Commenter: Lesser, Michael
Title: Cardiologist
Organization: Osler Medical
Date: 01/11/2008
Comment:

You've got to be kidding of course. This is an
extremely important step forward in eliminating
cardiac cathetherization, an invasive, costly
procedure. There will be an initial cost rise
associated with making this universal but a   More...



Commenter: Lester, MD, Patrick
Date: 01/08/2008
Comment:

I support CMS's decision to delay implementation
of Medicare payments for Coronary CTA until there
is adequate documentation that this procedure is
essentially equivelent to Contrast Angiography
clinically and is cost effective. <   More...



Commenter: Levin, Thomas
Title: Physician
Organization: Illinois Heart & Vascular
Date: 01/10/2008
Comment:

RE: Proposed Decision Memo for Computed
Tomographic Angiography (CAG-00385N)

We represent Illinois Heart and Vascular which
provides Cardiology services to the greater
Chicago land area. We have 27 physicians, 92
employees and s   More...



Commenter: Levine, Michael
Title: Radiologist
Organization: Lake Medical Imaging
Date: 01/10/2008
Comment:

I oppose the proposed national coverage policy
for coronary CTA for the following reasons:

• We disagree with CMS’ conclusions in the
proposed Coronary Artery CTA (CCTA) coverage
determination and believe that if implemented,    More...



Commenter: Levine, Marc
Title: Medical Director, Cardiac Imaging
Organization: Covenenant Medical Center
Date: 01/11/2008
Comment:

I strongly feel that coronary CT angiography is an invaluable tool
for patient care. Not only can it accurately identify the presence of
clinically important coronary artery disease, it can also accurately
exclude the diagnosis of obs   More...



Commenter: Lewis, Greg
Title: Physician
Organization: Illinois Heart and Vascular
Date: 01/10/2008
Comment:

RE: Proposed Decision Memo for Computed
Tomographic Angiography (CAG-00385N)

I represent Illinois Heart and Vascular which
provides Cardiology services to the greater
Chicago land area. We have 27 physicians, 92
employees an   More...



Commenter: Liang, Bruce
Date: 01/12/2008
Comment:

I am a board certified interventional
cardiologist. I have been practicing cardiology
for over 20 years. This proposed Medicare
position re Cardiac CTA is the worst decision re
the care of the American public. Coronary artery
   More...



Commenter: libach, L
Date: 01/11/2008
Comment:

RE:Medicare's announcement that a NCD will be
overturning the current Medicare's LCD's covering
cardiac CT angiography for the diagnosis of
coronary artery disease, except when patient is
enrolled in a research trial.

As    More...



Commenter: Licht, Mark
Title: M.D.
Organization: Radiology Associates of Clearwater
Date: 01/10/2008
Comment:
  • We disagree with CMS’ conclusions in the proposed Coronary Artery CTA (CCTA) coverage determination and believe that if implemented, the policy will be profoundly negative for Medicare beneficiaries by limiting their    More...


Commenter: Life, Brenda
Organization: North Ohio Heart Center
Date: 01/11/2008
Comment:

This endages the patients by cutting the
reimbursements for this for patients with cardiac
problems. Cardiac CT is of great benefit to
patient, cardiologist and families that rely on
this treatment to help them



Commenter: Lim, Philip
Date: 01/10/2008
Comment:

Your proposal to deny reimbursement for Cardiac CT is will severely impact negatively patient care. You should re-evaluate the literature which strongly supports its use to diagnose coronary artery disease. This test should be strongly endorsed by   More...



Commenter: Liu, Dr. Yi
Title: Radiologist
Organization: Lake Medical Imaging
Date: 01/10/2008
Comment:

I oppose the proposed national coverage policy
for coronary CTA for the following reasons:

• We disagree with CMS’ conclusions in the
proposed Coronary Artery CTA (CCTA) coverage
determination and believe that if implemented,    More...



Commenter: Loftis, Teresa
Date: 01/11/2008
Comment:

The diagnostic information a physician receives from a CTA of the Thorax includes not only the standard Pulmonary Arteries, Lungs and Mediastinum, they are privileged due to the advances in technology, to receive information on the heart and coron   More...



Commenter: Longi, Karen
Title: Radiologic technologist
Organization: Illinois Heart and Vascular
Date: 01/10/2008
Comment:

RE: Proposed Decision Memo for Computed
Tomographic Angiography (CAG-00385N)

We represent Illinois Heart and Vascular which
provides Cardiology services to the greater
Chicago land area. We have 27 physicians, 92
employees a   More...



Commenter: Loomer, Don
Date: 01/08/2008
Comment:

The data acted upon in this NCD was old and incomplete. This will deny needed, reasonable services to patients who will likely receive cardiac catheterization at a much higher cost. CMS should suspend its proposed NCD for two years and consider th   More...



Commenter: Loos, Stephen
Organization: Great Basin Imaging
Date: 01/08/2008
Comment:

January 8, 2008


Dear Centers for Medicare and Medicaid Services:

I strongly urge the Centers for Medicare and
Medicaid Services (CMS) to reconsider its
proposal and National Coverage Decision (NCD)
regarding coronary    More...



Commenter: Lopez, Eric
Title: M.D.
Organization: Radiology Associates of Clearwater
Date: 01/10/2008
Comment:
  • We disagree with CMS’ conclusions in the proposed Coronary Artery CTA (CCTA) coverage determination and believe that if implemented, the policy will be profoundly negative for Medicare beneficiaries by limiting their    More...


Commenter: Lukacs, MD, Jozsef
Date: 01/08/2008
Comment:

I wonder if this committee decision was made by
cardiologists who are less interested in this
technology for reasons of turf protection.



Commenter: Lyman, Pamela
Date: 01/10/2008
Comment:

Extensive research has been completed and is
readily available in cardialogy journals as well
as general medical journals. This research has
already shown the value and cost savings in using
CT angiography as well as cardiac CT.    More...



Commenter: Lyon, Robert
Date: 01/10/2008
Comment:

At our institution, we have been effectively using
a dual source CT unit to evaluate symptomatic
patients in low to intermediate clinical
probability categories for CAD to exclude
obstructive coronary artery disease in lieu of
inva   More...



Commenter: Macrum, Bruce
Title: Physician
Organization: Los Angeles Cardiology Associates
Date: 01/10/2008
Comment:

Patient care will be adversely affected if the
proposed restrictions and rules for cardiac CTA
are adopted.

1. CMS has not examined the full impact
this proposal will have on the Medicare
beneficiary. If the driver f   More...



Commenter: Mahannah, Teresa
Title: Executive Director
Organization: Reno Diagnostic Centers
Date: 01/12/2008
Comment:

I believe this coverage decision should remain regional and not national. We have been offering this service for over 1.5 years and has enabled many patients to avoid unneccessary invasive procedures, as well as saved lives. I have many examples I   More...



Commenter: Malik, Muhammad
Title: Cardiologist, MD FACC
Organization: HeartCare Midwest SC
Date: 01/10/2008
Comment:

The decision by CMS is extremely unfortunate and
does not accurately reflect an accurate
scientific assessment of the state of this
technology. The data used to generate this
decision was not complete and did not reflect
extrem   More...



Commenter: Malik, M.F.
Date: 01/12/2008
Comment:

Our group of 34 practicing cardiologists and
surgeons has been using cardiac CTA for over 1
year now. We have seen significant declines in
the number of patients requiring invasive
catheterizations. When properly used under
ACC   More...



Commenter: Malone, Tony
Date: 01/11/2008
Comment:

I guess I just don't understand why you wouldn't
cover the cost of CTA's. For the patients sake,
all they need to endure is a needle placed into
the arm, relax for an hour so the heartrate can
be lowered to an appropriate rate a   More...



Commenter: Marcus, MD, Richard
Date: 01/03/2008
Comment:

To Whom It May Concern:



I appreciate the opportunity to comment on the
proposed NCA for Computer Tomographic Angiography
(CAG-00385N). I am writing to express my concern
for the following.



The proposed    More...



Commenter: Mariano, D. James
Date: 01/09/2008
Comment:

While I understand your interest in curbing the
practise of performing tests which do not change
patient outcomes and increase the cost of health
care, I believe that eliminating coverage for
Coronary/Cardiac CT Angiography for any   More...



Commenter: Marino, Karen
Title: M.A.
Organization: Cardiovascular Management Of Illinois
Date: 01/11/2008
Comment:

RE: Proposed Decision Memo for Computed
Tomographic Angiography (CAG-00385N)

I represent Cardiovascular Management of Illinois
which provides Cardiology services to the greater
Chicagoland area. We have 19 physicians and serve <   More...



Commenter: Marmulstein, Michael
Date: 01/10/2008
Comment:

I believe that your planned NCD requiring a CED
for symptomatic intermediate risk patients ignors
the current state of the literature on CCTA and
will simply serve to restrict appropriate access
to less invasive testing of these pa   More...



Commenter: Marshall, Mylon
Date: 01/08/2008
Comment:

Coronary CTA is significantly less expensive than standard cardiac catheterization. It is also less invasive. Since up to 30% of cardiac catheterizations are negative, it makes fiscal and medical sense to encourage use of CCTA instead of cardiac c   More...



Commenter: Martin, Arthur
Title: Medical Director, Cardiovascular CT Angiography
Organization: Southern Heart Center, Hattiesburg Clinic
Date: 01/05/2008
Comment:

January 5, 2008

Joseph Chin, M.D.
JoAnna Baldwin, M.S.
Centers for Medicare and Medicaid Services
Department of Health and Human Services
P.O. Box 8014
Baltimore, MD 21244

RE: NCA for Computer Tomographic Angiography <   More...



Commenter: Martin, Sharon
Date: 01/10/2008
Comment:

RE: Proposed Decision Memo for Computed Tomographic Angiography (CAG-00385N)

I represent CARDIOVASCULAR ASSOCIATES, SC, which provides Cardiology services to the greater Elk Grove Village/Hoffman Estates, IL area. We have 19 physicians,    More...



Commenter: Mason, James
Date: 01/04/2008
Comment:

I am a cardiologist in Elk Grove, Illinois. I am
concerned about the elimination of reimbursement
for cardiac CTA being proposed by medicare(NCD).
Cardiac CTA is the most promising new technology
I have seen in 20 years. It quickly   More...



Commenter: Maxwell, Steve
Title: Sr Financial Manager
Organization: University of Michigan
Date: 01/11/2008
Comment:





January 11, 2008


Steve E. Phurrough, MD, MPA
Director, Coverage and Analysis Group
Centers for Medicare and Medicaid Services
Mailstop C1-09-06
7500 Security Blvd.
Baltimore, MD 21244-1850

R   More...



Commenter: Mayeda, Guy
Title: Physician
Organization: Los Angeles Cardiology Associates
Date: 01/10/2008
Comment:

Patient care will be adversely affected if the
proposed restrictions and rules for cardiac CTA
are adopted.

1. CMS has not examined the full impact
this proposal will have on the Medicare
beneficiary. If the driver f   More...



Commenter: McCallister, Jr, MD, Ben
Title: President
Organization: Michigan Heart, PC
Date: 01/12/2008
Comment:

I am a cardiologist in a large single specialty practice with 38-cardiologists and 10 mid level providers.  I have used cardiac CT angiography for the past 3 years with remarkable improvement in the care of my patients with    More...



Commenter: McCullough, Peter
Title: Division Chief
Organization: William Beaumont Hospital
Date: 12/27/2007
Comment:

Dear Sirs:

As a clinician I have found cardiac computed
tomographic angiography (CTA) a clinically
effective tool for the diagnosis, prognosis, and
management of patients with chronic coronary
artery disease. This form of i   More...



Commenter: McDowell, Rhonda
Title: M.D.
Organization: Radiology Associates of Clearwater
Date: 01/10/2008
Comment:
  • We disagree with CMS’ conclusions in the proposed Coronary Artery CTA (CCTA) coverage determination and believe that if implemented, the policy will be profoundly negative for Medicare beneficiaries by limiting their    More...


Commenter: McGuire, MD, Michael
Title: Staff cardiologist
Organization: Albuquerque Health Partners
Date: 01/10/2008
Comment:

Thank you for the opportunity to add my personal
comments to those of others in cardiology
regarding the upcoming decision on covered
diagnoses for Coronary CTA. I am confident you
are attempting to make recommendations which take   More...



Commenter: McGwier, MD, Bryan
Date: 01/11/2008
Comment:

We believe that the proposed NCD should be withdrawn or substancial modifications should be made to provide coverage for appropriate indications and populations.  Data is rapidly accumulating for 64-slice CCTA and there are    More...



Commenter: McIntyre, Richard
Date: 01/10/2008
Comment:

Disease prevention and early detection are keys
to reducing the rapid growth of health costs in
the U.S. Coronary artery disease will continue to
grow more prevalent in the aging U.S. population.
CTA provides an early detection opp   More...



Commenter: McRae, Roy
Title: MD
Organization: HeartCare Midwest
Date: 01/07/2008
Comment:

Cardiac CTA has proven to be a great help in
the management of my patients. It is especially
useful in patients with stress tests which I feel
are likely false positives and whom I would
previously be forced to perform an invasiv   More...



Commenter: Mehta, Ravi
Title: Medical Director, CTA
Organization: East Tennessee Heart Consultants
Date: 01/08/2008
Comment:

Our group of forty Cardiologists have adopted
Cardiac and peripheral CTA over the last year
and a half. We believe that this has a role in
diagnosis of CAD independent of Cardiac
catheterizations and myocardial perfusion scans.
   More...



Commenter: Melin, Gilbert
Date: 01/09/2008
Comment:

CMS has finally gone too far. To deny the
Medicare patient a test, that has been proven to
save both lives and money is criminal! This sort
of behavior should be policed by the government
and not developed by it. After many years of    More...



Commenter: Melvin MD FACC, Daryl
Date: 01/10/2008
Comment:

RE: Proposed Decision Memo for Computed Tomographic Angiography (CAG-00385N)

I am a cardiologist and a partner in a 22 physician cardiology practice in Lansing, MI.  On behalf of the physicians, s   More...



Commenter: Metz, Brian
Title: Cardiologist
Organization: Parkside Cardiology
Date: 01/10/2008
Comment:

The 2 acceptable categories for use of coronary
CTA are inappropriate. Unstable angina should be
evaluated by coronary angiography. We will never
use CCTA for this due to the additional contrast
and radiation needed for coronary    More...



Commenter: michaelson, gladys
Date: 01/09/2008
Comment:

Computed Tomographic Angiography when applied to
the appropriate setting ie: equiovcal stress
tests, can prevent the need for unnecessary
cardiac caths which will lead to savings for
medicare and medicaid. A CTA is less expensive    More...



Commenter: Middleton, Deneen
Title: charge entry coding and billing
Organization: CMI
Date: 01/11/2008
Comment:

RE: Proposed Decision Memo for Computed
Tomographic Angiography (CAG-00385N)

I represent Cardiovascular Management of Illinois
which provides Cardiology services to the greater
Chicagoland area. We have 29 physicians and serve    More...



Commenter: mikati, issam
Date: 01/11/2008
Comment:

It is critical that CMS continues to cover
CTA in order to save lives



Commenter: Mikolich, J. Ronald
Title: Chief, Section of Cardiology
Organization: Northeastern Ohio Universities College of Medicine(NEOUCOM)
Date: 01/12/2008
Comment:

January 10, 2008

To: Centers for Medicare and Medicaid Services
(CMS)

RE: Proposed National Coverage Decision(NCD) for
Cardiac Computed Tomography Angiography(CCTA)

The proposed NCD should be withdrawn as it will
ad   More...



Commenter: miller, allen
Date: 01/11/2008
Comment:

CTA is an exceptional diagnotic means to
determine CAD. It is imparative that
reimbursement for this procedure not be
overturned. CTA is now a more acceptable
diagnostic procedure that would eliminate other
diagnostic procedure   More...



Commenter: Mills, Richard
Date: 01/10/2008
Comment:

TALKING POINTS FOR LETTER TO CMS

• We disagree with CMS’ conclusions in
the proposed Coronary Artery CTA (CCTA)
coverage determination and believe that if
implemented, the policy will be profoundly
negative for Medicare    More...



Commenter: Mischen, Byron
Title: M.D.
Organization: Radiology Associates of Clearwater
Date: 01/10/2008
Comment:
  • We disagree with CMS’ conclusions in the proposed Coronary Artery CTA (CCTA) coverage determination and believe that if implemented, the policy will be profoundly negative for Medicare beneficiaries by limiting their    More...


Commenter: Mitchell, Mary Ellen
Title: Director of the Business Office
Organization: Cardiovascular Management of Illinois
Date: 01/11/2008
Comment:

RE: Proposed Decision Memo for Computed
Tomographic Angiography (CAG-00385N)

I represent Cardiovascular Management of Illinois
which provides Cardiology services to the greater
Chicagoland area. We have 19 physicians and serve <   More...



Commenter: Mohsin, Jamil
Organization: SJRA
Date: 01/11/2008
Comment:

The role of Coronary CTA has been well proven in
number of papers published in recent literature
across a variety of scientific journals. It is of
great benefit to the patient to have the
evaluation of the coronary arteries perform   More...



Commenter: Mordini, Federico
Date: 01/12/2008
Comment:

The decision by cms does not reflect the current
data that is known in the literature. There
currently very strong indications for ccta in
particular situations which exploint the
tremendous negative predictive value of the
te   More...



Commenter: Morris, Paula
Date: 01/11/2008
Comment:

I am a CT Technologist and I perform CTA's,
Cardiac's, Run-off's etc. I think that this
testing was a wonderful breakthrough for all of
these patients. And I know that results are very
conclusive. Please don't stop paying fo   More...



Commenter: Morris, Joel
Date: 01/10/2008
Comment:

I am a retired cardiac surgeon who has now
trained to read CTAs. What attracted me to this
procedure was the almost unbelievable pictures
of the whole coronary artery & not just the
lumen, as seen in angiography. For years I tried    More...



Commenter: Morris, William
Organization: Buffalo Medical Group
Date: 01/03/2008
Comment:

Dear Ms. Baldwin, I am presently an
Interventional Cardiologist in Buffalo New York,
and have achieved Level 2 training in Cardiac CT.
I believe currently there is a sufficient body of
evidence to support the good sensi   More...



Commenter: Morrison, Karen
Title: Vice President, Public Affairs
Organization: OhioHealth
Date: 01/11/2008
Comment:

OhioHealth is a not-for-profit organization providing healthcare services in 46 Ohio counties. As a leading healthcare provider in the Central Ohio community we are concerned with the proposed change in coverage for cardiac CT angiograms. Our phys   More...



Commenter: Moses, John
Title: President Wisconsin Heart & Vascular Institute
Date: 01/03/2008
Comment:

I strongly urge CMS to not move to block
utililization of Cardiac CT as currently approved
by all 50 state medicare carriers.
This action will dramatically hurt the patient
care I am able to provide my patients and will
ultima   More...



Commenter: Movahed, MD, FACC, FACP, Assad
Title: Professor of Medicine and Radiology
Organization: ECU Brody School of Medicine
Date: 01/11/2008
Comment:

The proposed NCD should be withdrawn. The proposed NCD does not adequately reflect the current state of evidence in support of CCTA in regard to symptomatic patients with chronic stable angina at intermediate risk of CAD. The requirement CMS has e   More...



Commenter: Mrugala, Beata
Title: Medical Records Auditor
Organization: Cardiovascular Management of Illinois
Date: 01/11/2008
Comment:

RE: Proposed Decision Memo for Computed
Tomographic Angiography (CAG-00385N)

I represent Cardiovascular Management of Illinois
which provides Cardiology services to the greater
Chicagoland area. We have 19 physicians and serve <   More...



Commenter: Mu, Nancy
Title: Regional Director
Organization: Illinois Heart and Vascular
Date: 01/10/2008
Comment:

RE: Proposed Decision Memo for Computed
Tomographic Angiography (CAG-00385N)

We represent Illinois Heart and Vascular which
provides Cardiology services to the greater
Chicago land area. We have 27 physicians, 92
employees a   More...



Commenter: Muhr, William
Date: 01/08/2008
Comment:

I urge CMS to reconsider the potentially
disastrous decision to cut off reimbursement for
coronary CTA (CCTA). Data suggest 1/3 of caths
the US are normal or show minimal disease, and
2/3 of pts do not undergo itervention at their    More...



Commenter: mullen, kathy
Date: 01/08/2008
Comment:

The CMS should take into consideration the
training involved not only for the technologists
in the field to perform CCTA accurately and with
diagnostic results, but also the time involved by
the Cardiologists and Radiologists invol   More...



Commenter: mullen, george
Title: MD
Organization: Cardiovascular Associates
Date: 01/10/2008
Comment:

RE: Proposed Decision Memo for Computed
Tomographic Angiography (CAG-00385N)

I am a physician partner representing
CARDIOVASCULAR ASSOCIATES, SC, which provides
Cardiology services to the greater Elk Grove
Village/Hoffman Es   More...



Commenter: Muller, MD, Reid
Title: Cardiologist
Organization: SJH Cardiology Associates
Date: 01/03/2008
Comment:

Cardiac CTA already has a 20 year track record of
research proving its clinical safety, relevance,
and efficacy. To restrict its use primarily to
clinical research trials flies completely in the
face of 20 years of research and tri   More...



Commenter: Mulrow M.D., John
Date: 01/06/2008
Comment:

1.CTA has diagnostic accuracy as compared to
conventional invasive angiography:Dr.Julie
Miller's recent study from Hopkins and the recent
ACCURACY trial.
2.CTA has decreased my catheterization volume in
certain patient populatio   More...



Commenter: Myers, Zac
Title: Executive Director
Organization: Tennessee Heart & Vascular Inst
Date: 01/12/2008
Comment:

Since 2004 new patient encounters in our
practice have increased by 22%. Yet in 2007 the
number of caths performed dropped 38% below that
of 3 years ago. The rate of normal caths has
dropped from 23% to 13% in the same period. The   More...



Commenter: Nagan, Michelle
Title: Patient Service Representative
Organization: Appleton Cardiology Associates, Ltd
Date: 01/09/2008
Comment:

I wish you would reconsider your proposal to cut
funding for CT Scans done by Cardiology groups. I
can't understand why you would want to pay $5,000
or more for an Invasive Cardiac Catherization.
When you have the CT Scan done at    More...



Commenter: Nguyen, Tuan
Title: M.D.
Organization: Texas Cardiovascular, P.A.
Date: 01/04/2008
Comment:

To whom it may concern:

I would like to express my concern over your National Coverage
Decision (NCD) proposal for Cardiac CTA (CCTA).

I completed a 7-month specialized training program in CCTA
and currently serve as the Ca   More...



Commenter: Niemeyer, John
Title: Chief of Radiology
Organization: Missouri Baptist Medical Center
Date: 01/10/2008
Comment:

Steve E. Phurrough, MC, MPA
Director
Coverage and Analysis Group, CMS
Re: CTA
Mailstop C1-09-06
7500 Security Blvd.
Baltimore, MD 21244-1850

Dear Dr. Phurrough:

I am writing to object to the National Coverage
De   More...



Commenter: Noah, Ralph
Title: Diagnostic Radiologist
Organization: Diagnostic Imaging Associates
Date: 01/08/2008
Comment:

This is from Tony Defrance, but I agree with it
so I am sending it although it is his words.

Commentary on CMS proposed NCD for Cardiac CTA.
As a physician who has been intimately involved
in cardiac CTA over the last six years I   More...



Commenter: Nolewajka MD, Andre
Date: 01/08/2008
Comment:

CTA of the coronary arteries is a fantastic tool
for the evaluation of patients with chest pain
syndromes. It has decreased the need for
coronary angiography especially in patients with
atypical chest pain and equivocal nuclear st   More...



Commenter: Nunnelly, David
Title: M.D.
Organization: Radiology Associates of Clearwater
Date: 01/10/2008
Comment:
  • We disagree with CMS’ conclusions in the proposed Coronary Artery CTA (CCTA) coverage determination and believe that if implemented, the policy will be profoundly negative for Medicare beneficiaries by limiting their    More...


Commenter: Nuss, Sandra
Title: Clinical Resource for ThedaCare CTC (training ctr)
Organization: ThedaCare
Date: 01/09/2008
Comment:

If the coronary CT is non-invasive and more
diagnostic why would you not want our senior
population to be able to utilize this technology?
Please consider if you were in their shoes, what
would you rather have done to diagnose coro   More...



Commenter: Oberst MD, Leslie
Title: Director of Cardiovascular Imaging
Organization: SCCT, NASCI, ACC, SCMR
Date: 01/03/2008
Comment:

I have been made aware of the recent
developements regarding CCTA reimbursement by
Medicare. The proposed NCD does not fully reflect
the current state of evidence. There are major
clinical studies that have been left out of
   More...



Commenter: Oddo, Barbara
Title: Registered Nurse
Organization: Cardiovascular Associates
Date: 01/10/2008
Comment:


RE: Proposed Decision Memo for Computed
Tomographic Angiography (CAG-00385N)

I represent Cardiovascular Associates (CVA),
which provides Cardiology services to the
greater Chicago, IL area. We have 19 physicians,
>50 emp   More...



Commenter: Odom, Lyn
Title: Driector Imaging Services
Date: 01/09/2008
Comment:

Why would you not consider patient safety, and
comfort when making these decisions. The
reduction of cost for CTA is worth consideration
alone. Using this tool to prevent much more
costly care after a debilitating that could have   More...



Commenter: Olson, Jeffrey
Organization: St. Paul Heart Clinic
Date: 01/06/2008
Comment:

I wish to express strong opposition to the
decision to eliminate reimbursement for cardiac
CTA pending data of it's efficacy and cost
effectiveness. This is a rapidly evolving
technology, but it is one that is providing real
   More...



Commenter: Opp, M.D., Randon
Date: 01/11/2008
Comment:

To Whom It May Concern:
I am very disappointed in CMS for considering a NCD which would further limit patient access to noninvasive coronary imaging, specifically CCTA (Coronary Computed Tomography Angiography). It is prem   More...



Commenter: Orr, Peggy
Date: 01/11/2008
Comment:

RE: Proposed Decision Memo for Computed
Tomographic Angiography (CAG-00385N)

I represent Cardiovascular Management of Illinois
which provides Cardiology services to the greater
Chicagoland area. We have 29 physicians and serve <   More...



Commenter: Ostrowski, Mary
Organization: Illinois Heart and Vascular
Date: 01/10/2008
Comment:

RE: Proposed Decision Memo for Computed
Tomographic Angiography (CAG-00385N)

We represent Illinois Heart and Vascular which
provides Cardiology services to the greater
Chicago land area. We have 27 physicians, 92
employees a   More...



Commenter: Owen, Lynda
Title: Business Office / EDI Coordinator
Organization: Cardiology Consultants of Johnson City, P.C.
Date: 01/10/2008
Comment:

The proposed NCD should be withdrawn. If it is
not withdrawn, substantial modifications should
be made to provide coverage for appropriate
indications and populations.

The proposed NCD does not adequately reflect the
curren   More...



Commenter: Owens, Sandra
Title: Supervisor Coding & Billing
Organization: CMI
Date: 01/10/2008
Comment:

RE: Proposed Decision Memo for Computed
Tomographic Angiography (CAG-00385N)

I represent Cardiovascular Management of Illinois
which provides Cardiology services to the greater
Chicagoland area. We have 19 physicians and serve <   More...



Commenter: Owens, Gary
Date: 01/08/2008
Comment:

This exam is absolutely necessary. Too many people are identified
with potential life-threatening conditions that would not have been
found otherwise. To not cover this exam is absurd. When compared
to the heart cath, this is not only    More...



Commenter: Pachulski, Roman
Date: 01/08/2008
Comment:

CTA is the state of the art noninvasive evaluation technique for
coronary disease dramatically surpassing nuclear stress testing and
eliminating the need for more noxious and costly invasive cardiac
catheterization.



Commenter: Pai, Ramdas
Date: 01/11/2008
Comment:

I am a cardiac imager, but I totally agree with
the CMS position that more evidence for benefit
is needed before more extensive use. There
already is abuse of the technology and
unnecessary exposure to radiation.



Commenter: Pandola, Maria
Title: Medical Asst.
Date: 01/10/2008
Comment:

RE: Proposed Decision Memo for Computed
Tomographic Angiography (CAG-00385N)

We represent Illinois Heart and Vascular which
provides Cardiology services to the greater
Chicago land area. We have 27 physicians, 92
employees a   More...



Commenter: Papi, Joseph
Date: 01/11/2008
Comment:

I have recently learned that Medicare is considering reducing coverage for Cardiac CTA based on the information or lack of information currently available.

As information, Cardiac CTA is one of the big   More...



Commenter: parker md, jacob
Title: Chief of Radiology and Nuclear Medicine
Organization: Ozarks Medical Center
Date: 01/12/2008
Comment:

Penny-wise and pound foolish. A coronary CTA is
much cheaper than a diagnostic catheter coronary
angiogram. It will obviate the normal catheter
study, thereby saving costs and cutting risks, as
it is non-invasive. Coronary calcium scor   More...



Commenter: parquette, Christine
Title: Office Coordinator
Organization: Cardiovascular Associates
Date: 01/10/2008
Comment:

)(electronic submission)



I represent CARDIOVASCULAR ASSOCIATES, SC, which
provides Cardiology services to the greater Elk
Grove Village/Hoffman Estates, IL area. We have
19 physicians, 85 employees and serve
approxim   More...



Commenter: Particka, Kay
Title: Ultrasound Technician
Organization: Hills and Dales General Hospital
Date: 01/10/2008
Comment:

I am disappointed that the "decision makers"
cannot see the importance and impact of taking
away vital coverage for such a non-invasive, yet
highly diagnostic test. Most people who receive
medicare coverage are older or compromised   More...



Commenter: Pasquale, Michael
Date: 12/30/2007
Comment:

December 28, 2007

CMS Proposed Decision on
Computed Tomographic Angiography

As a Cardiologist in private practice I have
found Cardiac CT angiography very helpful to my
patients who have symptoms    More...



Commenter: passmore, john
Title: Clinical Associate Professor of Medicine, UTMSH
Organization: FACC, FCCP
Date: 01/12/2008
Comment:

CT Coronary angiography is cheaper, less invasive
than standard coronary angiography, and has been
recently VALIDATED to be highly sensitive and
specific. What would you rather have to diagnose
your coronary disease, a cheap and sim   More...



Commenter: Patel, Anil
Title: M.D.
Organization: Radiology Associates of Clearwater
Date: 01/10/2008
Comment:
  • We disagree with CMS’ conclusions in the proposed Coronary Artery CTA (CCTA) coverage determination and believe that if implemented, the policy will be profoundly negative for Medicare beneficiaries by limiting their    More...


Commenter: Patel, Divyang
Title: M.D.
Organization: Radiology Associates of Clearwater
Date: 01/10/2008
Comment:
  • We disagree with CMS’ conclusions in the proposed Coronary Artery CTA (CCTA) coverage determination and believe that if implemented, the policy will be profoundly negative for Medicare beneficiaries by limiting their    More...


Commenter: Patel, Upen
Title: M.D.
Organization: Radiology Associates of Clearwater
Date: 01/10/2008
Comment:
  • We disagree with CMS’ conclusions in the proposed Coronary Artery CTA (CCTA) coverage determination and believe that if implemented, the policy will be profoundly negative for Medicare beneficiaries by limiting their    More...


Commenter: Patel M.D., Girish
Title: Radiologist / Director
Organization: Truxtun Radiology Medical Group
Date: 01/08/2008
Comment:

The proposed CMS restrictions for reimbursement
for cardiac CTA appear to be ill-conceived
regulation, which will severly affect the
preventive health care for Medicare recipients.

As a diagnostic radiolgist I have performed a <   More...



Commenter: Patel, MD, Smita
Title: Assistant Professor of Radiology
Organization: University of Michigan Medical Center
Date: 01/10/2008
Comment:

January 9, 2008


Steve E. Phurrough, MD, MPA
Director, Coverage and Analysis Group
Centers for Medicare and Medicaid Services
Mailstop C1-09-06
7500 Security Blvd.
Baltimore, MD 21244-1850

Re: Proposed National Cove   More...



Commenter: Patton, Mary
Title: Director, Market Research
Date: 01/08/2008
Comment:

My research company conducted a major independent survey of 200 U.S. cardiologists in 2006. This survey included questions about the use of CTA vs. cardiac catheterization. The data revealed that the cardiologists encounter many occasions where th   More...



Commenter: Paymani, Dr. Mahrad
Title: Radiologist
Organization: Lake Medical Imaging
Date: 01/10/2008
Comment:

I oppose the proposed national coverage policy
for coronary CTA for the following reasons:

• We disagree with CMS’ conclusions in the
proposed Coronary Artery CTA (CCTA) coverage
determination and believe that if implemented,    More...



Commenter: Pearson, M.D., John
Date: 01/11/2008
Comment:

I am in a group of seven cardiologists and found
CT angiography of the coronary very helpful in
diagnosing significant obstructive coronary
disease as well as identifying patients with
nonobstructive disease who would be treated wi   More...



Commenter: PECHE, GUS
Date: 01/11/2008
Comment:

I am writing to express my concern over a
National Coverage Decision (NCD) proposal that
CMS is making that will limit an important and
potentially lifesaving test to Medicare
beneficiaries.



Commenter: Pelberg, Robert
Title: Director, Regional SCCT Working Group
Organization: Ohio Heart and Vascular Center
Date: 12/27/2007
Comment:

To Whom it May Concern,

I am greatly troubled by the new proposed CME NCD
on cardiac CTA.

The proposed NCD does not fully reflect the
current state of evidence in support of CCTA in
regard to symptomatic patients with ch   More...



Commenter: Pelikan, Peggy
Date: 01/10/2008
Comment:

CT Angiography is an advancement that will
drastically impact the world of patients with
cardiac disease. It enables faster, more
accurrate and less invasive diagnosis. In the
end, studies are showing it decreases the number
of   More...



Commenter: pennisi, alfio
Date: 01/11/2008
Comment:

Coronary artery CTA can save patient morbidity and mortality by replacing invasive ,riskier, cardiac catheterization with a non-invasive technique. The negative predictive value is unequalled by any other test.Meaning: if your Coronary CTA is norm   More...



Commenter: Pepper, Kevin
Date: 01/08/2008
Comment:

We do not need to limit reimbursement for CCTA.
This is an extraordinary procedure that evaluates
coronary walls and lumens to detect deadly
vulnerable plaque that diagnostic caths cannot.
The general public shall benefit from this    More...



Commenter: PEREZ, BRENDA
Date: 01/11/2008
Comment:

I am writing to express my concern over a
National Coverage Decision (NCD) proposal that
CMS is making that will limit an important and
potentially lifesaving test to Medicare
beneficiaries.



Commenter: peter, Arley
Date: 01/04/2008
Comment:

1. CMS has not examined the full impact
this proposal will have on the Medicare
beneficiary. If the driver for this proposal is
the fear of misuse of a technology, there is no
credible published evidence to substantiate that    More...



Commenter: Peterkin, Ian
Title: physician
Date: 01/10/2008
Comment:

To whomever at CMS makes decisions regarding
cardiac CTangiography and will thus likely be
affecting tens of thousands of lives each year:

Cardiac CT angiography [CCTA] which I perform
as a diagnostic radiologist - as do thou   More...



Commenter: Petras, Steve
Date: 01/10/2008
Comment:

Reniging on the Medicare reimbursement of CCTA
would greatly penalize a large portion of the US
population by blocking their access to a less
invasive means of diagnosis; of particular note
is the impact on the elderly and those of   More...



Commenter: petre, luiza
Title: MD
Organization: The Associates of Columbia Presbyterian Heart Instutute
Date: 01/12/2008
Comment:

We performed a study that is accepted to be
presented at ACC 2008: We evaluated 75
consecutive patients who were referred to our
institution for further evaluation of a chest
pain syndrome following an abnormal stress test.
By C   More...



Commenter: Petrella, Patricia
Title: Housewife
Date: 01/12/2008
Comment:

CAT of the coronary arteries using 64 slice and
above is a proven lifesaver that has the
potential for big savings for CMS and all payors.

It's negative predictive value is 98-99% and
saves patients worry and annual testing for   More...



Commenter: Petrella, Edward
Title: Chairmen of Radiology Virtua, CEO South Jersey Rad
Organization: South Jersey Radiology and Virtua Health system
Date: 01/09/2008
Comment:

The patient with chest pain presenting to an
internist or a family practicioner can follow one
of two paths.

1: Send the patient to a cardiologist for a
consult. The cardiologist will always order a
stress echo. Unle   More...



Commenter: Petrone, Thomas
Date: 01/10/2008
Comment:

Has CMS determined the savings associated with
early diagnosis of heart disease? It appears not.
Another example of decision making as with DRA.



Commenter: Petruschak, Michael
Title: MD
Date: 01/09/2008
Comment:

Please reconsider the premature decision to not
pay for coronary CT angiography. This test will
revolutionize the diagnosis of heart disease
which is the leading cause of death in the United
States. I urge you to reconsider. Thank   More...



Commenter: Phillips MD, Minta
Title: Radiologist
Organization: Greensboro Radiology
Date: 01/11/2008
Comment:

Hello, as a practicing radiologist in Greensboro,
NC. I disagree with CMS’ conclusions in this
proposed coverage determination and believe that
if implemented, the policy would have a
profoundly negative impact on Medicare
bene   More...



Commenter: Pickard, George
Title: Dir of Ops
Organization: Reno Diagnostic Centers
Date: 01/12/2008
Comment:

Please continue covering CCTA exams. They are a
great non-invasive indicator for risk of heart
attack. The non-invasive nature results in a
lower morbidity over conventional angiography.
I implore that you do not further impede    More...



Commenter: Pollick, Charles
Organization: Los Angeles Cardiology Associates
Date: 01/04/2008
Comment:

Patient care will be adversely affected if the
proposed restricions and rules for cardiac CTA
are adopted.

1. CMS has not examined the full impact
this proposal will have on the Medicare
beneficiary. If the driver for   More...



Commenter: Ponder, Richard
Date: 01/08/2008
Comment:

I recently read about CMS announced intention to
issue an NCD for CCTA. As a patient with CAD, I
am shocked at the short-sighted nature of the CMS
proposal. CCTA offers a much lower cost and
effective means of intitial determinat   More...



Commenter: Posteraro III, Anthony
Title: Director, Cross Sectional Cardiovascular Imaging
Organization: St Francis Hospital and Medical Center
Date: 01/04/2008
Comment:

I am the director of cross sectional cardiovascular imaging at St
Francis Hospital Medical Center in Hartford Connecticut. My
practice involves imaging the heart with most techniques.

I have been contacted by a special interest g   More...



Commenter: Prasifka, Stacie
Title: CEO
Organization: North Texas Heart Center, P.A.
Date: 01/11/2008
Comment:

RE: Proposed Decision Memo for Computed
Tomographic Angiography (CAG-00385N)

We represent North Texas Heart Center, P.A.,
which provides Cardiology services to the
greater Dallas/Ft. Worth, Texas area. We have 15
physicians,   More...



Commenter: Pratt, Hope
Date: 01/11/2008
Comment:


Comment: Please do not restrict access to CTA.
We live in Washington
County Maine - a remote rural area. A large
portion of our
citizens are poor and/or elderly. Our community
hospital is
small but well staffed: we h   More...



Commenter: Pratt, Joel
Title: Retired
Date: 01/09/2008
Comment:

Please do not restrict access to CTA. We live in Washington
County Maine - a remote rural area. A large portion of our
citizens are poor and/or elderly. Our community hospital is
small but well staffed: we have a cardiology team on    More...



Commenter: Pronesti, Lori
Date: 01/11/2008
Comment:

Additional cuts in reimbursement affects not only
physicians but their employees as well. With
expenses continuing to increase and reimbursement
being cut this is going to affect the hourly wage
employees and supportive staff.

   More...


Commenter: PURCELL, TROY
Title: PRACTICE ADMINISTRATOR
Organization: LAKE MEDICAL IMAGING
Date: 01/10/2008
Comment:
  • We disagree with CMS’ conclusions in the proposed Coronary Artery CTA (CCTA) coverage determination and believe that if implemented, the policy will be profoundly negative for Medicare beneficiaries by limiting their    More...


Commenter: Purcell, Lee
Title: M.D.
Organization: Radiology Associates of Clearwater
Date: 01/10/2008
Comment:
  • We disagree with CMS’ conclusions in the proposed Coronary Artery CTA (CCTA) coverage determination and believe that if implemented, the policy will be profoundly negative for Medicare beneficiaries by limiting their    More...


Commenter: Putnam, Donna
Date: 01/12/2008
Comment:

CCTA coverage should continue to be covered for
the following reasons:

1. based on our year and a half experience CCTA
provides accurate and non-invasive diagnostic
information regarding coronary artery disease
and the risk    More...



Commenter: Quinn, Kevin
Title: Staff Radiologist
Organization: Catholic Medical Center
Date: 01/12/2008
Comment:

I am a board certified radiologist in New
Hampshire who has specialized in invasive and
noninvasive cardiac and noncardiac imaging for the
past 21 years. I have personally interpreted over
500 CCTA exams in the past 2 years.

I S   More...



Commenter: Quinn, Bruce
Title: MD
Organization: Physician
Date: 12/27/2007
Comment:

One of the bullet points regarding therapeutic
outcomes (used earlier in draft clinical trial NCD
language) remains extremely confusing and the
grammar probably does not reflect CMS's intention.
Then section is:
"The research stud   More...



Commenter: Raff, Gilbert
Title: MD
Organization: Director, Ministrelli Center for Advanced Cardiovascular Imaging
Date: 12/18/2007
Comment:

As a clinician and active researcher in the field
of coronary CT angiography, I am concerned that
the proposed CED will inhibit the very outcomes
research CMS is attempting to encourage.

Our ability to pursue randomized controll   More...



Commenter: Raghavan, Narasimhachari
Date: 01/08/2008
Comment:

When looking at a test, one has to look at the
big picture. Looking at the cost of CCTA without
considering the savings of not doing coronory
angiograms leads to false conclusions. A better
way to reduce costs would be to prohibi   More...



Commenter: Ram, MD, Sunil
Date: 01/11/2008
Comment:

Proposed National Coverage Determination for
Coronary CT Angiography (CAG-00385N)

I am writing in response to the proposed national
coverage determination (NCD) for coronary CT
angiography (CCTA) recently publicized by
Medi   More...



Commenter: Raman, S
Date: 12/22/2007
Comment:

The proposed NCD does not fully reflect the
current state of evidence in support of CCTA in
regard to symptomatic patients with chronic
stable angina at intermediate risk of CAD.
Data is rapidly accumulating for 64-slice CCTA
an   More...



Commenter: Ramsey, Laurie
Title: Director
Organization: CMI
Date: 01/10/2008
Comment:

RE: Proposed Decision Memo for Computed
Tomographic Angiography (CAG-00385N)

I represent CARDIOVASCULAR ASSOCIATES, SC, which
provides Cardiology services to the greater Elk
Grove Village/Hoffman Estates, IL area. We have
19   More...



Commenter: Ramsey, Howard
Title: M.D.
Organization: Intervential Cardiologist of Gainesville
Date: 01/11/2008
Comment:

To whom it may concern: I am an invasive and clinical cardiolgist in private practice in Gainesville, Florida. We do CCTA in our office and it has changed the way we practice cardiology in that our overall care is less invasive, more effecient, an   More...



Commenter: Randle, Emily
Title: Executive Director, Ancillary Services
Organization: Orange Coast Memorial Medical Center
Date: 01/09/2008
Comment:

I oppose CMS' proposal to restrict access to
this valuable non invasive technology to
Medicare beneficiaries...the very population who
are taken to cath labs and OR's unnecessarily
and at increased risk for diagnosis of cardiac <   More...



Commenter: Ranginani, Anil
Date: 01/05/2008
Comment:

I strongly urge you to re evaluate the existing
data before making this decision. There is
extensive data and literature in USA and in the
world about the role of CTA in assement of
coronary artery disease. This technology is
e   More...



Commenter: Rasband, Dan
Date: 01/11/2008
Comment:

<->The proposed NCD should be withdrawn. If it is not
withdrawn, substantial modifications should be made to provide
coverage for appropriate indications and populations.
<->The proposed NCD does not adequately reflect the current
s   More...



Commenter: Reddy, Venoodhar
Title: Physician
Organization: Cardiovascular Associates
Date: 01/11/2008
Comment:

RE: Proposed Decision Memo for Computed
Tomographic Angiography (CAG-00385N)

I represent CARDIOVASCULAR ASSOCIATES, SC, which
provides Cardiology services to the greater Elk
Grove Village/Hoffman Estates, IL area. We have
19   More...



Commenter: Reddy, Sora
Date: 01/09/2008
Comment:

Joseph Chin, M.D.
JoAnna Baldwin, M.S.
Centers for Medicare and Medicaid Services
Department of Health and Human Services
P.O. Box 8014
Baltimore, MD 21244

Dear Dr. Chin and Ms. Baldwin:

Cardiovascular Medicine P.C. (C   More...



Commenter: Redenz, Michelle
Organization: Cardiovascular Associates SC
Date: 01/10/2008
Comment:

RE: Proposed Decision Memo for Computed
Tomographic Angiography (CAG-00385N)

I represent CARDIOVASCULAR ASSOCIATES, SC, which
provides Cardiology services to the greater Elk
Grove Village/Hoffman Estates, IL area. We have
19   More...



Commenter: Reed, Jeffrey
Title: RN - Clinical Manager Cardiac & Neurovascular Ser
Organization: Exempla Healthcare
Date: 01/10/2008
Comment:

Re: Medicare Program; Proposed National Coverage
Determination (NCD) Memo for Cardiac Computed
Tomography Angiography (CCTA), CAG-00385N



I am writing to express my concerns regarding the
inpatient payment proposed rule    More...



Commenter: Reif, Lawrence
Title: Director Radiology, Past President Medical Staff
Organization: United Hospital System, Kenosha WI
Date: 01/12/2008
Comment:

I would like to encourage CMS to accept the
position advocated by ACR and SCCT on the CCTA
NCD. While I understand the concern about further
accelerating the rising cost of healthcare, the
anecdotal experience we have had in Kenosha wi   More...



Commenter: Renehan, Richard
Title: RN
Date: 01/08/2008
Comment:

This modality enables patients with abnormal
imaging studies from nuclear or stress echo to
have a fast, safe, non invasive test to determine
the extent of coronary artery disease without
having to undergo the expense and risk of    More...



Commenter: Richards, David
Title: Director, Cardiac CT
Organization: MidOhio Cardiology & Vascular Consultants
Date: 01/12/2008
Comment:


To Whom It May Concern:


Like many physicians involved in cardiac CTA, I
am quite surprised by the newly proposed NCD by
CMS for cardiac CTA. Multiple societies (ACC,
ACR, SCCT, ASNC, ASNC, SCAI, NASCI, and SCMR)
have   More...



Commenter: Riddle, Amy
Title: M.D.
Organization: Radiology Associates of Clearwater
Date: 01/10/2008
Comment:
  • We disagree with CMS’ conclusions in the proposed Coronary Artery CTA (CCTA) coverage determination and believe that if implemented, the policy will be profoundly negative for Medicare beneficiaries by limiting their    More...


Commenter: Ridner, Michael
Title: Director, Cardiac CT Angiography
Organization: The Heart Center, Huntville, AL
Date: 01/12/2008
Comment:

I appreciate the opportunity to respond and
provide comments regarding the CMS proposed NCD
for Cardiac CT Angiography.

I was deeply saddened when I learned of CMS’s
decision to issue a restricted NCD for Cardiac
CT Angiogra   More...



Commenter: Rios, Alvaro
Date: 01/12/2008
Comment:

1. I am a board certified cardiologist.
This proposed Medicare position re Cardiac CTA
goes againstthe future of preventive cardiology
and better management of pts with CAD. I spent
$10000 for training without owing a machine jus   More...



Commenter: Riter, Henry
Title: Fellow, Division of Cardiovascular Medicine
Organization: University of Iowa Hospitals & Clinics
Date: 01/06/2008
Comment:

I strongly oppose the proposed restrictions for cardiac CT. As a fellow in training I have received extensive training in the technique and have significant experience in correlating findings with nuclear perfusion studies and invasive angiography   More...



Commenter: Rivas, Enrique
Date: 01/10/2008
Comment:

In regards to CCTA: I found it useful in
selected population. This SINGLE test allowed to
diagnose extensive CAD of moderate severity in a
patient with dyslipidemia as single risk factor,
atypical CP and reluctancy to primary
p   More...



Commenter: Rodgers, Denise
Title: Director Imaging Services, UCR
Organization: Intermountain Healthcare
Date: 01/08/2008
Comment:

I think a more productive way to control costs
would be to 1) reimburse these studies in
hospital sites only (no free standing) and 2) in
sites that have a program where both Cardiologist
and radiologist work together. That way, y   More...



Commenter: Rodriguez, Cesar
Organization: Cigarroa Heart & Vascular Institute
Date: 01/11/2008
Comment:

I am writing to express my concern over a
National Coverage Decision (NCD) proposal that
CMS is making that will limit an important and
potentially lifesaving test to Medicare
beneficiaries.

Cesar Rodriguez



Commenter: Rokey, Roxann
Title: MD, FACC, FASE
Organization: Marshfield Clinic
Date: 01/08/2008
Comment:

As a noninvasive cardiologist and former
invasive cardiologist, with extensive experience
and usage of all cardiac nonivasive and invasive
imaging modalities for coronary artery disease
and congenital heart disease, the decision of   More...



Commenter: Rollings, Robert
Title: Cardiologist
Organization: Savannah Cardiology, P.C.
Date: 12/22/2007
Comment:

Some may wonder if this proposed decision memo for CTA is a
“perfect storm.” Alas, there is no mystery to the proven physics
or utility of coronary angiography using computed tomography
versus invasive catheter based techniques, there   More...



Commenter: Rosamond, FACC, FASE, FAHA, Thomas L.
Title: Medical Director of Nuclear Cardiology
Organization: Mid-America Cardiology
Date: 01/09/2008
Comment:

The proposed changes for cardiac CTA as
described in the current National Coverage
Determination (NCD) is probably one of the most
conspicuously unilateral, special interest
influenced, penny-wise and pound foolish
decisions to   More...



Commenter: Rothschiller, David
Title: Executive Director
Organization: St. Paul Heart Clinic, P.A.
Date: 01/11/2008
Comment:

January 11, 2008

Attn: Steve Phurrough, M.D.M.P.A.
Director, Coverage and Analysis Group
Centers for Medicare and Medicaid Services

From: The St. Paul Heart Clinic Physicians and
Dave Rothschiller

RE: Proposed Deci   More...



Commenter: Rough, Randy
Date: 01/03/2008
Comment:

To Whom It May Concern:



I appreciate the opportunity to comment on the
proposed NCA for Computer Tomographic Angiography
(CAG-00385N). I am writing to express my concern
for the following.



The proposed    More...



Commenter: Roybal, Donald
Title: CT Coordinator
Date: 01/10/2008
Comment:

I believe that cardiac cta is a new and
developing technology, that deserves the
complete evaluation with all sources of
information available. From
Radiologists,Cardiologists and Industry leaders
presenting their data. With th   More...



Commenter: Rubin, Bruce
Title: Medical Director, Cardiac Imaging
Organization: Washington Adventist Hospital
Date: 01/10/2008
Comment:

I disagree with the CMS conclusions in the
proposed coverage determination and believe that
if implemented, the policy would have a
significantly negative impact on medicare
beneficiaries by limiting access for clinically
appro   More...



Commenter: Rucker, MD, Don
Title: VP, Chief Medical Officer
Organization: Siemens Medical Solutions USA Inc
Date: 01/11/2008
Comment:

January 11, 2008

Steve E. Phurrough, MD, MPA
Director
Coverage and Analysis Group, CMS
Re: CTA
Mailstop C1-09-06
7500 Security Blvd.
Baltimore, MD 21244-1850

Marcel Salive, MD, MPH
Director, Division of Medical a   More...



Commenter: Rumberger, John
Title: Director of Cardiac Imaging
Organization: The Princeton Longevity Center
Date: 01/09/2008
Comment:

To Whom it May Concern,

I am greatly troubled by the new proposed CME
NCD on cardiac CTA (CCTA); it is not well
initiated and is not in the patient’s best
interest.

First, let me give you my background. I am a
forme   More...



Commenter: Rusk, Yvonne
Organization: Appleton Cardiology
Date: 01/11/2008
Comment:

I really do not think the cuts that you are
considering for Cardiology for 2008 is right.
Our patients need to have these diagnostic
procedures done and with the cuts that we have
heard about the reimbursement would not even
c   More...



Commenter: Rybicki, Frank
Title: Director of Cardiac CT and Vascular CT/ MRI
Organization: Brigham and Women''s Hospital and Harvard Medical School
Date: 01/11/2008
Comment:

Note: This letter with the table and references
will be emailed as an attachment

Re: Centers for Medicare & Medicaid Services
proposed National Coverage Determination for
Cardiac Computed Tomography

We represent Brigham a   More...



Commenter: Safriel, Yair
Title: M.D.
Organization: Radiology Associates of Clearwater
Date: 01/10/2008
Comment:
  • We disagree with CMS’ conclusions in the proposed Coronary Artery CTA (CCTA) coverage determination and believe that if implemented, the policy will be profoundly negative for Medicare beneficiaries by limiting their    More...


Commenter: Sales, Gregory
Title: Director of Clinical Education
Organization: Emergency Cardiac Imaging
Date: 12/21/2007
Comment:

The proposed NCD does not fully reflect the
current state of evidence in support of CCTA in
regard to symptomatic patients with chronic
stable angina at intermediate risk of CAD.
Data is rapidly accumulating for 64-slice CCTA
an   More...



Commenter: Saltiel, Frank
Title: Physician
Organization: Illinois Heart and Vascular
Date: 01/04/2008
Comment:

Cardiac CTA is a proven and extremely useful
addition to the armamentarium of the
cardiologist. As an interventional
cardiologist, I can assure you that it clearly
and dramatically reduces the need for invasive
coronary angiog   More...



Commenter: Salvato, Robin
Title: Patient Care Specialist
Organization: Illinois Heart and Vascular
Date: 01/10/2008
Comment:

RE: Proposed Decision Memo for Computed
Tomographic Angiography (CAG-00385N)

We represent Illinois Heart and Vascular which
provides Cardiology services to the greater
Chicago land area. We have 27 physicians, 92
employees a   More...



Commenter: Samaraweera, Ranji
Title: Chairman, Department of Radiology
Organization: Sparrow Hospitals and Clinics
Date: 01/11/2008
Comment:

Proposed National Coverage Determination for
Coronary CT Angiography

Thank you for the opportunity to comment on the
NCD.

The department of Radiology and the Sparrow
Hospitals and Clinics strongly urge CMS to
maintain   More...



Commenter: Sanchez, Robert
Organization: Heart & Vascular Institute of Florida
Date: 01/11/2008
Comment:

The proposed NCD should be withdrawn. If it is
not withdrawn, substantial modifications should
be made to provide coverage for appropriate
indications and populations. The proposed NCD
does not adequately reflect the current state    More...



Commenter: Saremi, Farhood
Title: Professor of radiology
Organization: UCI
Date: 01/12/2008
Comment:

I am a radiologist. License # A66413. This is my
objection to new decision of medicare regarding
cardiac CTA reimbursement. This precedure is the
result of years of effort of scientist to produce
images and has a major impact on pa   More...



Commenter: Sassani, Alex
Title: Radiologist
Organization: UCLA
Date: 01/08/2008
Comment:

Dear CMS,
If your mother, father, husband, or wife had
chest pain, would you like for them to have an
invasive conventional coronary angiogram or a non-
invasive coronary CTA? I know I would select
coronary CTA for my family memb   More...



Commenter: Sauri, Daniel
Date: 01/11/2008
Comment:

RE: Proposed Decision Memo for Computed
Tomographic Angiography (CAG-00385N)

I represent Cardiovascular Associates, which
provides Cardiology services to the greater Elk
Grove Village, IL area. We have 19 physicians, 75
empl   More...



Commenter: Savage, Kenneth
Date: 01/08/2008
Comment:

If the patient's accessability to new, efficient
and less invasive technology is considered not
important enough to be a priority, then
healthcare will suffer and remain decades behind
in possible advancement. This has been the <   More...



Commenter: Schaefer, Chris
Date: 01/08/2008
Comment:

I''ve just heard that CMS is proposing to limit
reimbursement for coronary CTA. Not only is this
short-sighted, it is just plain wrong. Denying
patients'' access to a potentially life saving
technology will not save money in    More...



Commenter: Schertz, Brad
Date: 01/09/2008
Comment:

I currently work as a Registered Nurse in an
outpatient Cardiology clinic that has a 64 slice
CT scanner. I see first hand how this technology
and machine has saved lives, time, and money.

We were involved with a study from G   More...



Commenter: Schick, David
Date: 01/10/2008
Comment:

We disagree with CMS’ conclusions in the
proposed Coronary Artery CTA (“CCTA”) coverage
determination and believe that if implemented,
the policy will be profoundly negative for
Medicare beneficiaries by limiting their access <   More...



Commenter: Schmedtje, John
Title: Executive Director
Organization: Roanoke Heart Institute
Date: 01/10/2008
Comment:

As a practicing Cardiologist and clinical
investigator, I wholeheartedly endorse the
response of the SCCT to the proposed NCD. That
said, I would also support an increased
allocation of federal funds for research to
increase ou   More...



Commenter: Schneider, Cheryl
Title: Compliance Officer
Organization: North Ohio Heart Center, Inc.
Date: 01/11/2008
Comment:

It is unbelievable that CMS would consider non-
coverage for Cardiac CTA as the cost savings for
those patients not needing further cardiac
catheterization is enormous. Patients benefit
from this non-invasive procedure that gives <   More...



Commenter: Schraner, Albert
Date: 01/08/2008
Comment:

To restrict medicare reimbursement for Coronary
CT angiography is a step backward for medical
technology at the risk of compromising patient
care. Here we have a relatively new well-
researched means of detecting coronary blockages   More...



Commenter: Schussheim, Adam
Date: 01/12/2008
Comment:

Such Draconian limitations on a new technology make it seem
that all the frustrations on ballooning medical costs, declining
funds, and financial scrutiny are serving up this promising
modality as a sacrifice on the alter of sanctimoni   More...



Commenter: Schwartzberg, Dr. Marc S.
Title: Radiologist
Organization: Lake Medical Imaging
Date: 01/10/2008
Comment:

I oppose the proposed national coverage policy
for coronary CTA for the following reasons:

• We disagree with CMS’ conclusions in the
proposed Coronary Artery CTA (CCTA) coverage
determination and believe that if implemented,    More...



Commenter: Seeck, Brian
Title: Physician
Date: 01/12/2008
Comment:

I am a practicing cardiologist who has been
trained in cardiac CT through fellowship at
Washington University. I have published abstracts
and interpreted hundreds of clinical and research
cases. I am concerned not only about the poss   More...



Commenter: Seltzer, Jeff
Date: 01/11/2008
Comment:

The proposed NCD should be withdrawn. If it is
not withdrawn, substantial modifications should
be made to provide coverage for appropriate
indications and populations.
The proposed NCD does not adequately reflect the
current sta   More...



Commenter: Seltzer, Steven
Title: Chair, Department of Radiology
Organization: Brigham and Women''s Hospital
Date: 01/09/2008
Comment:

9 January 2008
Subject: Proposed Decision Memo for Computed
Tomographic Angiography (CAG-00385N)

Dear CMS,

I am the Chairman of the Department of Radiology
at Brigham and Women’s Hospital and the Philip H
Cook Professo   More...



Commenter: Sena, Laureen
Title: Staff Radiologist
Organization: Boston Children''s Hospital
Date: 01/11/2008
Comment:

I am a pediatric radiologist who performs
coronary CTA and Cardiac MR in pediatric patients
with congenital heart disease, which includes
patients who can have coronary artery anomalies,
such as anomalous origin or to follow-up cor   More...



Commenter: Sergi, Thomas
Date: 01/12/2008
Comment:

CCTA can save patient morbidity and mortality by
replacing cath with a non-invasive technique.
The NPV of CCTA is unequalled by any other test.
Recent 64 slice and better literature confims
this and supports outstanding PPV as we   More...



Commenter: Serio, Joseph
Title: Executive Director
Organization: RAdiology of Huntsville, P.C.
Date: 01/11/2008
Comment:

I disagree with CMS' conclusions in the proposed
coverage determination. I believe that this
policy would negatively impact Medicare
beneficiaries access for clinically appropriate
indications to this non-invasive technology. Th   More...



Commenter: Shah, Rakesh
Title: director of CCTA
Organization: Comprehensive Cardiology
Date: 01/01/2008
Comment:

The developement of CCTA has been an incredible innovation
which has allowed patients access to non-invasive technology by
which a detailed anatomical assessment may be performed in a
way never possible before. The prognostic informat   More...



Commenter: Shah, MD, FACC, Tushar
Title: Cardiologist
Organization: PriMed Cardiology
Date: 01/07/2008
Comment:

Cardiovascular Computed Tomography and
A Positive-Sum Strategy in Cardiovascular Medicine

Recently the practice and politics of medicine
have demonstrated a tendency towards a zero-sum
strategy, one that is not focused on optimizi   More...



Commenter: Shamblin, Kim
Organization: South Charleston Cardiology
Date: 01/07/2008
Comment:

To Whom It May Concern,


I am writing to express my concerns regarding the
proposed National Coverage Decision (NCD) for
Cardiac CTA. If this proposal is implemented it
would set cardiac diagnosis in a ba   More...



Commenter: Shamsi, Abdul
Title: M.D.
Organization: Radiology Associates of Clearwater
Date: 01/10/2008
Comment:
  • We disagree with CMS’ conclusions in the proposed Coronary Artery CTA (CCTA) coverage determination and believe that if implemented, the policy will be profoundly negative for Medicare beneficiaries by limiting their    More...


Commenter: Shapiro, Michael
Title: Director, Cardiac CT
Organization: Oregon Health & Science University
Date: 01/10/2008
Comment:

I am deeply disturbed with the proposed NCD. It does not adequately reflect the current state of evidence in support of coronary computed tomographic angiogrpahy (CCTA) in regard to symptomatic patients with chronic stable angina at intermediate r   More...



Commenter: Shavelle, David
Title: Physician
Organization: Los Angeles Cardiology Associates
Date: 01/10/2008
Comment:

Patient care will be adversely affected if the
proposed restrictions and rules for cardiac CTA
are adopted.

1. CMS has not examined the full impact
this proposal will have on the Medicare
beneficiary. If the driver f   More...



Commenter: sheinberg, jon
Date: 01/12/2008
Comment:

DONT CUT CTA!!!



Commenter: Shen, Jason
Title: Physician (Cardiologist)
Organization: Jason Shen, M.D., F.A.C.C., Inc.
Date: 01/10/2008
Comment:

The proposed NCD for cardiac CT angiography is
too restrictive and would negatively impact the
care of many patients with atypical angina and
indeterminate stress test results. These
patients would be forced to undergo higher risk   More...



Commenter: sher, scott
Date: 01/08/2008
Comment:

The proposal to limit payment on coronary CTA is
quite concerning. Coronary CTA has the potential
to significantly reduce the number of negative
stress tests and coronary catheterizations.

Negative coronary caths are a particu   More...



Commenter: shields, marjorie sue
Title: RN
Organization: Illinois Heart and Vascular
Date: 01/11/2008
Comment:

Proposed Decision Memo for Computed Tomographic
Angiography (CAG-00385N)

We represent Illinois Heart and Vascular which
provides Cardiology services to the greater
Chicago land area. We have 27 physicians, 92
employees and s   More...



Commenter: Shin, M.D., Hae
Date: 01/12/2008
Comment:

I have personally performed CCTAs for almost 3
years now. I have seen many cases of unsuspected
severe stenoses of the coronary arteries which
were potentially life-threatening. On the other
hand, there have also been many cases wh   More...



Commenter: Shivalkar, Bharati
Title: Prof. Dr.
Organization: Antwerp University Hospital
Date: 01/12/2008
Comment:

The NCD proposed by the CMS is premature, grossly
unjust, and tries to crush a promising new technology
such as cardiac computed tomography angiography
(CCTA) without giving it ample opportunity to prove
itself further in the diagn   More...



Commenter: Sholes, MD, Christopher
Title: President and CEO
Organization: Cardiology Consultants of Johnson City, P.C.
Date: 01/03/2008
Comment:

The proposed NCD does not fully reflect the
current state of evidence in support of CCTA in
regard to symptomatic patients with chronic
stable angina at intermediate risk of CAD.

Data is rapidly accumulating for 64-slice CCTA    More...



Commenter: Sigurdsson, Gardar
Date: 01/11/2008
Comment:

Canceling all payments for CTA of the coronaries
is not appropriate and would reflect poorly on
CMS and other governmental institutions.

The CTA technology is in its infancy and multiple
researchs studies are underway to try to   More...



Commenter: Simons, Richard
Title: Clinical Cardiologist
Date: 01/11/2008
Comment:

I would like to comment regarding
the proposed and national coverage decision
regarding cardiac CTA. As a community-based
clinical cardiologist I have grown to appreciate
the unique capabilities of cardiac CTA in th   More...



Commenter: Simopoulos, Chris
Date: 01/08/2008
Comment:

Coronary CTA WILL save you money, not cost you
more money. Plus, the less cardiac
catheterizations performed, the less
complications there will be with non-invasive
CCTA. Don't you guys care about your patients
anymore? Hav   More...



Commenter: Simpson, Robert
Date: 01/09/2008
Comment:

Medicare wants to restrict the access of this
technology, and has made this proposal over the
Christmas/New Years Holidays, with a deadline for
response from physicians and the public on
January 12th, 2008.

Instead of havi   More...



Commenter: Singh, H.Paul
Title: Medical Director
Organization: West Michigan Cardiology.
Date: 01/10/2008
Comment:

We have used CTA heart over the last about 2
years to diagnose CAD. I have saved so many
patients from undergoing cardaic cathetrizations.
As we all know that everybody who undergoes
cardiac cath does not need cabg or PTCA/ stent. <   More...



Commenter: singh MD, MPH, FACC, pradeep
Organization: Carolina Cardiology associates
Date: 01/10/2008
Comment:

I am a practicing cardiologist with office based 64 slice ct angio facility. I feel that 64 slice ct has played a very clear role in assessing the patients for indeterminte nuclear stress tests and also abnormal stress tests. A n   More...



Commenter: Siragusa, Roy
Date: 01/08/2008
Comment:

This is a life saving modality. The benefit is
significant, like in the article; Arch. Internal
Med. 2007 Aug 13-27; 167(15): 1686-9

DO NOT CUT THIS LIFE SAVING TOOL. THE LIFE YOU
SAVE MAY BE YOUR OWN.



Commenter: Sireci, Steven
Date: 01/08/2008
Comment:

Comments re: NDC, Administrative File: CAG
00385N Computed Tomographic Angiography

I disagree wholeheartedly with CMS’s conclusions
in its proposed coverage determination regarding
coronary CT angiography (CCTA). If implemente   More...



Commenter: Skaf, Michel
Date: 01/11/2008
Comment:

The availability of the CTA of the heart was
great for our patient population. It gave
patients a choice and it avoided invasive and
costly cardiac catheterization in many of these
patient. It is a great tool if it is used
co   More...



Commenter: Sklar, Mitchel
Date: 01/08/2008
Comment:

I would urge repeat evaluation. This technology
is very useful as a non-invasive method or
evaluating patients will avoid the potential
risks of a coronary angiogram. The literature
supports its utility and safety. This endorsement   More...



Commenter: Slomin, Glenn
Date: 01/11/2008
Comment:

I understand the concern of CMS about
inappropriate use of cardiac/coronary CTA. I will
advise to use the medical society guidelines
(appropriateness criteria), rather than this
drastic decision that will affect patient care.
   More...



Commenter: Smart, Frank
Title: Chairman Department of Cardiovascular Medicine
Organization: Atlantic Health System and The Gagnon Heart Hospital
Date: 01/10/2008
Comment:

This change in reimbursement will actually
increase cost for CMS and other payers. The
frequency of low and intermediate chest pain
admissions continues to climb with multiple tests
and hospital confinement to avoid litigation seen   More...



Commenter: Smith, Timothy
Title: Director of Medical Imaging & Laboratory
Organization: Iroquois Memorial Hospital & Resident Home
Date: 01/11/2008
Comment:

CCTA is a diagnostic tool that aids in the
determination of CAD. Patients that are at risk
and who are having undiagnosed Chest Pain or
other complications can be safely and
conveniently scanned to determine if a more
invasive   More...



Commenter: Smith, Kimberly
Title: Business Coordinator
Organization: Atlantic Health System/Morristown Memorial Hospital
Date: 01/11/2008
Comment:

I support the continued CMS payment for
outpatient CTA 100%!!!!




Commenter: Smith, Christine
Date: 01/10/2008
Comment:

RE: Proposed Decision Memo for Computed Tomographic Angiography (CAG-00385N)

I represent CARDIOVASCULAR ASSOCIATES, SC, which provides Cardiology services to the greater Elk Grove Village/Hoffman Estates, IL area. We have 19 physicians,    More...



Commenter: Smuclovisky, MD, Claudio
Title: Director
Organization: S. Florida Medical Imaging Cardiovascular Institutte
Date: 01/09/2008
Comment:

Thank you for the opportunity to comment on this
most important issue. As Director the SFMI
Cardiovascular institute and having personally
interpreted over 6,000 cardiac CTA’s (CCTA) , I
can categorically state that CCTA is among of t   More...



Commenter: Snider, MS, RT(R), Shawn
Title: Administrative Director, Radiology
Organization: CoxHealth
Date: 01/08/2008
Comment:

While I understand the desire on the part of CMS
to limit payment for CCTA to medically necessary
cases, I believe it circumvents the true power of
this technology: To diagnose coronary artery
disease in individuals who are at risk   More...



Commenter: snyderman, richard
Date: 01/10/2008
Comment:

This is a procedure that is obviously a benefit to
residents in a state such as Maine with a limited
number of major medical facilities and a small
rural population spread out widely in a huge
state. Any procedure which speeds up deliv   More...



Commenter: Sortur, Amarnath
Date: 01/09/2008
Comment:

Good Decision. This will prevent abuse by
cardiologists, radiology groups for all chest
pain. This will curtail and prevent the rapid
rate of growth in Multislice CT as promoted by
the manufacturers so that there is a balance in <   More...



Commenter: Sovinec, Dawn
Title: CEO
Organization: Wisconsin Heart and Vascular Institute
Date: 01/11/2008
Comment:

RE: Proposed Decision Memo for Computed
Tomographic Angiography (CAG-00385N)

I represent Wisconsin Heart and Vascular
Institute, which provides Cardiology services to
the greater Madison, Wisconsin area. We have 14
physician   More...



Commenter: Sparks, Darlene
Title: Executive Assistant
Organization: North Ohio Heart Center
Date: 01/11/2008
Comment:

I am appalled at the attempt to limit any
patient's access to Computed Tomographic
Angiography! A vast number of patients, either
due to ignorance, denial, fear or complicating
health conditions, will never agree to undergo
c   More...



Commenter: Spencer, Robert
Title: Physcian
Organization: Cardiology Consultants, PC
Date: 01/07/2008
Comment:

7 January 2008

Dear Steve E. Phurrough, MD, MPA
Director, Coverage and Analysis Group
Regarding Proposed Coverage Decision Memorandum for Cardiac Computed Tomographic Angiography for the Diagnosis of Coronary Artery Disease   More...



Commenter: Squires, Jonathan
Title: D.O.
Organization: Radiology Associates of Clearwater
Date: 01/10/2008
Comment:
  • We disagree with CMS’ conclusions in the proposed Coronary Artery CTA (CCTA) coverage determination and believe that if implemented, the policy will be profoundly negative for Medicare beneficiaries by limiting their    More...


Commenter: Stang, Kim
Date: 01/10/2008
Comment:

RE: Proposed Decision Memo for Computed
Tomographic Angiography (CAG-00385N)

We represent Illinois Heart and Vascular which
provides Cardiology services to the greater
Chicago land area. We have 27 physicians, 92
employees a   More...



Commenter: Staniszewski, D.C., Susan
Organization: Individual
Date: 01/11/2008
Comment:

Cardiac CT Angiography (CCTA) is vital for the
care of chest pain patients. This procedure
provides a non-invasive, low-risk method of
confirming coronary artery blockage without the
invasive and high risk catheterization
proc   More...



Commenter: Steadman, Brent
Date: 01/10/2008
Comment:

I disagree with your recent proposal for NCD.
CCTA is a good and valid test, that effectively
replaces the more expensive and invasive
diagnostic coronary catherization. Studies are
even showing the potential to replacement
ex   More...



Commenter: Stein, MD, Jonathan
Title: MD
Organization: Jonathan H. Stein, MD
Date: 01/11/2008
Comment:

Please do not stop coverage for coronary CTA. It
is a valuable procedure that provides a safer,
less painful, less expensive alternative to
cardiac catheterization. It is much preferred by
patients since it is much less uncomfortab   More...



Commenter: Steinberg MD, David
Title: Managing Partner
Organization: SDMI
Date: 01/09/2008
Comment:

CTA has all but replaced conventional and
digital angiography.
Does cardiac CTA have the ability to diagnose
or exclude coronary artery disease as well as
invasive coronary angiography?

A normal or negative CTA has a greater   More...



Commenter: Stephenson, Lance
Date: 01/11/2008
Comment:

I would like to urge you to continue to reimburse
for CT coronary argio studies. In our experience
with this test it has proven to be a reliable,
cost effective alternative to standard coronary
angiography. For those people with el   More...



Commenter: Stern, George
Title: M.D.
Organization: Radiology Associates of Clearwater
Date: 01/10/2008
Comment:
  • We disagree with CMS’ conclusions in the proposed Coronary Artery CTA (CCTA) coverage determination and believe that if implemented, the policy will be profoundly negative for Medicare beneficiaries by limiting their    More...


Commenter: Steward, Kendra
Date: 01/11/2008
Comment:

RE: Proposed Decision Memo for Computed
Tomographic Angiography (CAG-00385N)

I represent Cardiovascular Management of Illinois
which provides Cardiology services to the greater
Chicagoland area. We have 19 physicians and serve <   More...



Commenter: Stidham, Susan
Title: Director of Radiology
Organization: Premier Imaging/Encompass Medical Group
Date: 01/10/2008
Comment:

We have been doing CTA coronary since Sept 2007.
The patients we have found this to be most useful
in are patients that we need to exclude coronary
artery disease. The literature and our
experience suggest that the best indicatio   More...



Commenter: Stifter, William
Title: MD
Organization: Heart Clinics Northwest
Date: 01/10/2008
Comment:

EIGHT specialty societies have outlined the
appropriateness criteria for CCTA published in
the July 2006 issue of the Journal of the
American College of Cardiology.It is well known
that published reports lag one to two years
be   More...



Commenter: Stolte, David
Title: Manager, Non-invasive Cardiology
Organization: Swedish Health System
Date: 01/11/2008
Comment:

For CMS to submit the proposed NCD would be a
monumental mistake. This decision is unfounded
and flies in the face of documented, validated
expert opinion and would deprive patients of a
critical diagnostic tool. This outcome wou   More...



Commenter: Storts, Amanda
Title: Facilities Manager
Organization: Lake Medical Imaging
Date: 01/10/2008
Comment:

TALKING POINTS FOR LETTER TO CMS

· We disagree with CMS’ conclusions in
the proposed Coronary Artery CTA (CCTA)
coverage determination and believe that if
implemented, the policy will be profoundly
negative for M   More...



Commenter: sudarshan, sriram
Title: M.D.,F.A.C.C
Organization: NORTH TEXAS CARDIOLOGY CENTER
Date: 01/05/2008
Comment:

As a provider CTA of Heart and Practicing Cardiologist for over 27
years,I have realised CTA of Heart is the single most important
diagnostic tool that has developed thus for for the diagnosis of
CAD.
Please do not deprive my patien   More...



Commenter: Sundaram, MD, Baskaran
Title: Assistant Professor of Radiology
Organization: University of Michigan Medical Center
Date: 01/10/2008
Comment:


January 8, 2008

Steve E. Phurrough, MD, MPA
Director, Coverage and Analysis Group
Centers for Medicare and Medicaid Services
Mailstop C1-09-06
7500 Security Blvd.
Baltimore, MD 21244-1850

Re: Proposed National Cove   More...



Commenter: Suplica, Jeffrey
Date: 01/08/2008
Comment:

The decision to limit CCTA (Cardiac CT) may be
somewhat short-sighted or ill-informed. The
alternative to non-invasive CCTA (with a 99%
negative predictive value) is an invasive, in-
hospital, cardiac angiography (note that 1/3 of    More...



Commenter: Swartzendruber, Kelly
Date: 01/10/2008
Comment:

I am a very disappointed healthcare employee. I
think that ctas's are a very important part of
diagnostic testing. i think of my family and
friends that may need this testing and will not
be able to due to insurance not covering   More...



Commenter: Sweeney, Laurel
Title: Sr. Director Reimbursement & Legislative Affairs
Organization: Philips Healthcare
Date: 01/11/2008
Comment:

January 11, 2008

Joseph Chin, MD
Director, Coverage and Analysis Group
Centers for Medicare and Medicaid Services
Mail Stop C1-09-06
7500 Security Boulevard
Baltimore, Maryland 21244-1850

ELECTRONICALLY SUBMITTED
Su   More...



Commenter: Sweet, Rodger
Title: Assistant Information Technology Director
Organization: Lake Medical Imaging and Vascular Institute
Date: 01/10/2008
Comment:

Dear Sirs,

Please use the following issues with regard to my
views of the pending legislation regarding CCTA
items coming before your body.

• We disagree with CMS’ conclusions in the
proposed Coronary Artery CTA (CCTA)    More...



Commenter: Szawaluk, John
Title: MD
Organization: The Ohio Heart & Vascular Center
Date: 01/07/2008
Comment:

To Whom it may concern:
I am confused and saddened by the CMS NCD for
cardiac CTA. I urge CMS to consider the rapidly
accumulating and robust data for cardiac CTA. The
proposed guidelines are unfair and suffocating.
Moreover,   More...



Commenter: Taylor, Grover
Title: Director of Radiology
Organization: Weatherford Regional Hospital
Date: 01/11/2008
Comment:

Ladies and Gentlemen, Aa the director of
Radiology in a rural hospital, I see first-hand
the multitudes of elderly patients who do not
have the ways and means to travel to distant
medical centers for diagnostic CAD procedures.
   More...



Commenter: Tejani MD, FACC, Furqan
Date: 01/11/2008
Comment:

I am attaching a reference to the article we just
published in a peer reviewed journal that attests
to the ability of MDCT in identifying anomalies
of the coronary arteries.


Qamar UR, Khan MU, Umair S, Tejani F, Khan IA.
   More...



Commenter: Tesoriero, Mary
Title: Administrative Director Radiology Services
Organization: Community Medical Center
Date: 01/11/2008
Comment:

It is well documented that CCTA has substantial
clinical utility in ruling out coronary disease
in both acute care and non-acute care settings.
Denying coverage for CCTA for the diagnosis of
CAD will limit Medicare patients’ access   More...



Commenter: Thiel, Gay
Title: Finance Director
Organization: Medical Financial Management
Date: 01/12/2008
Comment:

CCTA coverage should continue to be covered for
the following reasons:
1. based on our year and a half experience CCTA
provides accurate and non-invasive diagnostic
information regarding coronary artery disease
and the risk of i   More...



Commenter: thomas, marc
Title: MD
Organization: summit radiology PC
Date: 01/10/2008
Comment:

I am a practicing radiologist and am also the Carrier Advisory
Committee representative for radiology in Indiana. This
proposed National Coverage Determination for coronary CTA is a
good example of why the medical community has no con   More...



Commenter: Thompson, Tamar
Title: Manager, Healthcare Economics
Organization: Bracco Diagnostics Inc.
Date: 01/11/2008
Comment:

Dear Doctor Phurrough:

Thank you for providing Bracco Diagnostics Inc.
(Bracco) with this opportunity to submit
comments on the Proposed Decision Memo for
Computed Tomographic Angiography (CTA). Bracco
is a global manufactu   More...



Commenter: Tilton, Gregory
Date: 01/12/2008
Comment:

I am against CMS withdrawing payment for 64-
slice cardiac CT. I personally am very
sympathetic to CMS''s concern about oversue of
technology by cardiologists. But we must learn
another method beside punishing all members of
t   More...



Commenter: Tri, Terry
Title: President
Organization: South Georgia Cardiology
Date: 01/10/2008
Comment:

This decision is terribly short sighted. There is
a large group of patients, particularly female,
who have slghtly atypical acut or chronic pain
syndromes, a modicum of risk factors, and
abnormal stress tests in whom CCTA is incred   More...



Commenter: TRIOLO, MD, JOSEPH
Title: Chairman of Radiology
Organization: Medical Radiology Group
Date: 01/11/2008
Comment:

CCTA is a cost effective examination which can,
in the proper setting, expedite patient care and
reduce unnecessary testing. Although CCTA may
not have a significant role in the elderly, the
younger, active Medicare participants m   More...



Commenter: Tucker, Paul
Title: M.D.
Organization: Texas Cardiovascular Consultants
Date: 01/09/2008
Comment:

The decision to non-cover CTA is misguided, based
on an incomplete review of the available
evidence, and is purely driven by the
government's desire to save money at the expense
of medicare beneficiaries lives.
I use this techn   More...



Commenter: Tuite, Michael
Date: 01/09/2008
Comment:

We believe that it will be Medicare beneficiaries
who will suffer if the proposed National Coverage
Determination (NCD) is put in place for CCTA
(Computed Coronary Tomography Angiography).

As proposed, the NCD severely restricts   More...



Commenter: Tunick MD FACC, Stephen
Date: 01/10/2008
Comment:




I am writing to express my concern over a
National Coverage Decision (NCD) proposal that
CMS is making that will limit an important and
potentially lifesaving test to Medicare
beneficiaries. The procedure that they wan   More...



Commenter: Tunio, Javed
Date: 01/10/2008
Comment:

The proposed NCD should be withdrawn. If it is
not withdrawn, substantial modifications should
be made to provide coverage for appropriate
indications and populations.
The proposed NCD does not adequately reflect the
current sta   More...



Commenter: turner, md , facc, michael clair
Title: Director of Cardiac CTCSSW ACC governor for La.
Organization: Cardiovascular Specialists of Southwest La.
Date: 01/04/2008
Comment:

I am the director of cardiac CT in a busy
cardiology group practice. We have utilised
cardiac CT angiography effectively in our
practice for the last two years.
I can speak for my group that we have found this
imaging modality t   More...



Commenter: Usher, Theresa
Organization: cardiovascular management of illinois
Date: 01/11/2008
Comment:

RE: Proposed Decision Memo for Computed
Tomographic Angiography (CAG-00385N)

I represent Cardiovascular Management of Illinois
which provides Cardiology services to the greater
Chicago land area. We have 19 physicians and
se   More...



Commenter: Vaisman, Uri
Title: Radiologist
Date: 01/08/2008
Comment:

Coronary CTA, especially in the setting of a
small rural Critical Access Hospital with a busy
Emergency Department and no cardiac center
within 25 miles is CRITICAL in the evaluation of
patients with atypical chest pain or in the <   More...



Commenter: VALLS, PATRICK
Date: 01/11/2008
Comment:

I am writing to express my concern over a
National Coverage Decision (NCD) proposal that
CMS is making that will limit an important and
potentially lifesaving test to Medicare
beneficiaries.



Commenter: van Beek, Edwin
Title: Professor of Radiology, Medicine and Biomed. Eng.
Organization: University of Iowa
Date: 01/11/2008
Comment:

I would like to most strongly protest against the
proposed changes as intended in the NCD mentioned
above. As program director for our cardiac CT
program, I have extensive experience with the
patients you are trying to restrict. Fu   More...



Commenter: Van Wormer MD,RVT,RDCS, Mark
Title: MEDICAL DIRECTOR DIAGNOSTIC IMAGING
Organization: UNION COUNTY MEDICAL AND DIAGNOSTIC IMAGING CENTER PC
Date: 01/09/2008
Comment:

As a physician working for the last 27 years in a
Rural Health Manpower Shortage area and a
practicing Echo and Vascular Tech, I perform many
non invasive tests to identify coronary disease
before it kills my patients. I now have o   More...



Commenter: VanBenthuysen MD, Karyl
Title: President
Organization: South Denver Cardiology Associates
Date: 01/11/2008
Comment:

Dear Sirs: As a practicing cardiologist, I would
like to strongly object to the proposed NCD and
as that it be withdrawn. It is difficult to uned
how this decision has been made in the face of a
rapidly expanding data set which wil   More...



Commenter: Vanhoenacker, Piet
Date: 01/11/2008
Comment:

1: Vanhoenacker PK, Decramer I, Bladt O, Sarno G,
Bevernage C, Wijns W.
Detection of non-ST-elevation myocardial
infarction and unstable angina in the
acute setting: meta-analysis of diagnostic
performance of multi- detector
   More...



Commenter: VanOss, Jack
Title: CT Applications Coordinator
Organization: Spectrum Health
Date: 01/10/2008
Comment:

The proposed NCD should be withdrawn. If it is
not withdrawn, substantial modifications should
be made to provide coverage for appropriate
indications and populations.
• The proposed NCD does not adequately reflect
the current s   More...



Commenter: Vazquez-Bauza, Juan J
Title: Cardiologist, MD, FACC
Organization: Mid Aerica Cardiovascular Institute
Date: 12/18/2007
Comment:

First of all thanks for the opportunity on
commenting on the Proposed Decision Memo on
Computer Topographic Angiography (CAG-00385N)
dated December 13, 2007.

This memo of health care rationing is one with
multiple flaws and    More...



Commenter: Verhey, Margaret
Title: M.D.
Organization: Iowa Heart Center
Date: 01/05/2008
Comment:

We have been using coronary CTA in clinical
practice and have found it to be very useful in
selected patients. The current proposal for its
use is too restrictive.

I personally found it to be the most helpful
when it is nor   More...



Commenter: Verma, Adarsh
Title: M.D.
Organization: Radiology Associates of Clearwater
Date: 01/10/2008
Comment:
  • We disagree with CMS’ conclusions in the proposed Coronary Artery CTA (CCTA) coverage determination and believe that if implemented, the policy will be profoundly negative for Medicare beneficiaries by limiting their    More...


Commenter: Victorson, Judith
Title: Executive Director
Organization: Cardiac Care
Date: 12/27/2007
Comment:

PROPOSED NCD FOR CORONARY CTA: I am writing to
request reconsideration of the proposed NCD for
Coronary CTA. This NCD unfairly limits access
to Coronary CTA services for Medicare
beneficiaries. Coronary CTA services have three <   More...



Commenter: VILLARREAL, GENARO
Date: 01/11/2008
Comment:

I am writing to express my concern over a
National Coverage Decision (NCD) proposal that
CMS is making that will limit an important and
potentially lifesaving test to Medicare
beneficiaries.



Commenter: Voice, Ronald
Title: Cardiologist
Organization: Thoracic and Cardiovascular Institute
Date: 01/11/2008
Comment:

RE: Proposed Decision Memo for Computed
Tomographic Angiography (CAG-00385N)

I am a cardiologist and a partner in a 22
physician cardiology practice in Lansing, MI. On
behalf of the physicians, staff and patients at
Thoraci   More...



Commenter: Vollman D.O. FAOCR, Dennis
Title: President
Organization: Southgate Radiology
Date: 01/10/2008
Comment:

My Imaging Center has been performing CTA exam of the neck,
head, abdomen and lower extremities for over three years. We
have performed well over 500 exams. Over the past year we
have also performed CCTA on over 100 patients. We have c   More...



Commenter: WAGNER, GAYLE
Date: 01/10/2008
Comment:

RE: Proposed Decision Memo for Computed
Tomographic Angiography (CAG-00385N)

We represent Illinois Heart and Vascular which
provides Cardiology services to the greater
Chicago land area. We have 27 physicians, 92
employees a   More...



Commenter: Walsh, Ronald
Organization: Heart & Vascular Institute of Florida-North
Date: 01/11/2008
Comment:

The CT coronary angiography is a unique
technology which is a much better predictor of
coronary events than stress testing and can lead
to less invasive coronary angiography in
intermediate-risk patients. There is a need for
e   More...



Commenter: Wann, Samuel
Title: Cardiologist
Organization: Wheaton Franciscan Medical Group
Date: 01/11/2008
Comment:

Coronary CTA has become an important part of my
practice. It saves my patients from having
unnecessary cardiac catheterizations, and avoids
long stays in the emergency room. There is
little doubt that coronary CTA is a cost
ef   More...



Commenter: Watanabe, Alyssa
Date: 01/10/2008
Comment:

Coronary CTA using 64 slice CT and above is
effective with much literature now published
that is not included in your review. Prior
literature based on CT 16 slice and under should
not be considered as relevant.

This pro   More...



Commenter: WEATHERS MD, LARRY
Date: 01/12/2008
Comment:

We have not reduced the incidence of sudden
cardiac death in 50 years. cardiac ct is the only
current way to find atherosclerosis early and
treat it. If you wish to prevent sudden cardiac
death approve cardiac ct nothing else can d   More...



Commenter: Weiss, Mason
Title: Managing Partner
Organization: Apex Cardiology Consultants
Date: 01/12/2008
Comment:

This is a peer reviewed technology which has
time and agin demonstrated its efficacy.

PLEASE change your decision!!!

Cardiovascular Computed Tomographic
Angiography: What You Need to Know

• CCTA is appropriate:
o T   More...



Commenter: Weiss, Alex
Title: M.D.
Organization: Radiology Associates of Clearwater
Date: 01/10/2008
Comment:
  • We disagree with CMS’ conclusions in the proposed Coronary Artery CTA (CCTA) coverage determination and believe that if implemented, the policy will be profoundly negative for Medicare beneficiaries by limiting their    More...


Commenter: Weiss, Mitchell
Title: M.D.
Organization: Radiology Associates of Clearwater
Date: 01/10/2008
Comment:
  • We disagree with CMS’ conclusions in the proposed Coronary Artery CTA (CCTA) coverage determination and believe that if implemented, the policy will be profoundly negative for Medicare beneficiaries by limiting their    More...


Commenter: west, kimberly
Title: payment poster
Date: 01/10/2008
Comment:

electronic submission)


RE: Proposed Decision Memo for Computed
Tomographic Angiography (CAG-00385N)

I represent Cardiovascular Management of Illinois
which provides Cardiology services to the greater
(name of city/sta   More...



Commenter: Wexler, Lewis
Title: Professor Emeritus of Radiology
Organization: Stanford University School of Medicine
Date: 01/12/2008
Comment:

As a former president of the North American
Society for Cardiac Imaging (NASCI) and the
Society for Cardiac Angiography and Interventions
(SCAI), a Fellow of the American College of
Radiology and the American College of Cardiology,
   More...



Commenter: Wey, MD, Robert J
Title: Interventional Cardiologist
Date: 01/12/2008
Comment:

My license number is TX E4113. I am a board
certified interventional cardiologist. This
proposed medicare position re Cardiac CTA is the
single worst decision re the care of the American
public I have seen in 40 years of front line   More...



Commenter: Weyn, Dr. David C.
Title: Radiologist
Organization: Lake Medical Imaging
Date: 01/10/2008
Comment:

I oppose the proposed national coverage policy
for coronary CTA for the following reasons:

• We disagree with CMS’ conclusions in the
proposed Coronary Artery CTA (CCTA) coverage
determination and believe that if implemented,    More...



Commenter: Whetzel, Sharon
Title: Director of Diagnostic Imaging
Organization: Carilion Clinic
Date: 01/11/2008
Comment:

I am not in favor of the CMS proposal for CTA
Cardiac reimbursements. This proposal appears to
be primarily based on the Blue Cross/Blue Shield
Technology Center reports from April 2006. These
are non-peer review reports produced    More...



Commenter: White, Charles
Title: Professor and Director Thoracic Radiology
Organization: University of Maryland Medical System
Date: 01/11/2008
Comment:

As a radiologist and director of a large cardiac
CTA program that has been active for more than
five years, I cannot agree with the proposed
coverage determination as outlined last month by
CMS. In our experience, the ability for    More...



Commenter: White, Michael
Date: 01/08/2008
Comment:

If I need a test to evaluate my coronary
arteries, my choice would be an accurate less
invasive test like the CTA. It is not good for a
patient to be told they can't have the best
imaging procedure to diagnose a life threatening <   More...



Commenter: Whitfield, Steven
Title: MD
Organization: Cardiology Services of Olathe Health systems
Date: 01/06/2008
Comment:

Steven S. Whitfield MD, FACC
4905 West 132 Street
Leawood, Ks 66209
Telephone: 913-897-5946
913-961-0105
Diplomate, American Board of Internal
Medicine,
Interventional Cardiology   More...



Commenter: Whitman, Andrew
Title: Vice President
Organization: Medical Imaging & Technology Alliance
Date: 01/12/2008
Comment:






January 11, 2008

Steve Phurrough, MD, MPA
Director, Coverage and Analysis Group

Marcel Salive, MD, MPH
Director, Division of Medical and Surgical
Services

Joseph Chin, MD, MS
Lead Medical Of   More...



Commenter: Wicks, Allan
Title: Cardiologist
Organization: Wyoming Cardiopulmonary Services, PC
Date: 01/11/2008
Comment:




RE: Proposed Decision Memo for Computed
Tomographic Angiography (CAG-00385N)
We represent Wyoming Cardiopulmonary Services, PC
which provides Cardiology services to the greater
Wyoming area. We have 6 physicians, 32 empl   More...



Commenter: Wiener, Jonathan
Title: Director MRI
Organization: Boca Raton Community Hospital
Date: 01/10/2008
Comment:

While it makes sense for CMS to scrutinize what
it pays for, it does not make sense to withold
reimbursement for coronary CTA which is one of
the greatest breakthroughs in imaging in the last
20 years. The issue of overutilization   More...



Commenter: Wilder, Wayne
Date: 01/10/2008
Comment:

CCTA is a safe, proven diagnostic technology that
is as effective at diagnosing CAD as a tradition
cath procedure (white costs more, has greater
risk to the pt. and possibly more radiation dose*)

***The new CT technology from To   More...



Commenter: Wilkerson, James E.
Title: Cardiologist
Organization: Magnolia Health Systems
Date: 01/09/2008
Comment:

The use of CT angiography provides medicare, and
other government payee receipients with a
procedure that has been shown to reduce the
frequency of coronary angiography procedures, in
an outpatient setting at a lower overall cost t   More...



Commenter: Wilks, Richard
Date: 01/09/2008
Comment:

I'm a general cardiologist with 16 years
practice experience.I tend to be conservative in
my approach to adopting new
therapies,devices,tests, etc.I have watched with
interest the development of CT cor
angiography.Because of t   More...



Commenter: Will, Peter
Date: 12/26/2007
Comment:

To Whom it May Concern,

I am greatly troubled by the new proposed CME NCD on cardiac CTA.

The proposed NCD does not fully reflect the current state of evidence in support of   More...



Commenter: Wilson, Robert
Date: 01/09/2008
Comment:

When used in appropiately selected patients, CTA
of the coronaries is extremely helpful. For the
intermediate-risk patient, CTA offers an
opportunity to obtain definitive information
about the coronary arteries with lower risk and   More...



Commenter: Wilson, MD, Dr. Brent
Date: 01/12/2008
Comment:

In Utah, Medicare has been slow to reimburse
coronary CT angiography, and this has led to the
need for more invasive and costly substitutes
(i.e. invasive angiography) in many patients
where that could have been avoided. The curren   More...



Commenter: WITTRY, MD, MARK D .
Date: 01/12/2008
Comment:

Lets leave politics out of it. CTA is cost
effective when used with the appropriate
indications. Refusal to reimburse this exposes
these individuals to either sub standard
technology or the inherent risks of invasive
angiograph   More...



Commenter: Woodford, David
Title: Director, Radiology Services
Organization: Heywood Hospital
Date: 01/08/2008
Comment:

As a community hospital without a cardiac cath
lab the use of cardiac CT angiography is an
important service for our patients with atypical
chest pain. Often patients that have an
equivocal or undiagnostic stress test or nuclear <   More...



Commenter: Wright, Lisa
Date: 01/10/2008
Comment:

I don't underestand why CMS would want to limit
use of a procedure that may provide a less
invasive alternative to patients who are at risk
of heart disease. It is my understanding that the
alternative to this treatment is an angi   More...



Commenter: Yamada, Gregg
Title: Private Clinician
Organization: Pacific Cardiology, LLC
Date: 01/04/2008
Comment:

Thank you for allowing our comments regarding
proposed NCD for cardiac CT imaging.

As a private clinician, cardiac CTA has resulted
in a substantial cost savings to CMS/Noridian and
our local private insurers due to a decrease   More...



Commenter: Yao, Jiefen
Date: 01/08/2008
Comment:

To whom it may concern,

I am writing to express my concern over a
National Coverage Decision (NCD) proposal that
CMS is making that will limit an important and
potentially lifesaving test to Medicare
beneficiaries. You want    More...



Commenter: Yoakum, MaryAnn
Title: Auditor
Organization: LMI-LEESBURG
Date: 01/10/2008
Comment:

We disagree with CMS’ conclusions in the proposed
Coronary Artery CTA (CCTA) coverage
determination and believe that if implemented,
the policy will be profoundly negative for
Medicare beneficiaries by limiting their access
t   More...



Commenter: Yoskin, Dr. Maurice P.
Title: Radiologist
Organization: Lake Medical Imaging
Date: 01/10/2008
Comment:

I oppose the proposed national coverage policy
for coronary CTA for the following reasons:

• We disagree with CMS’ conclusions in the
proposed Coronary Artery CTA (CCTA) coverage
determination and believe that if implemented,    More...



Commenter: Young, David
Date: 01/12/2008
Comment:

Thank you for the opportunity to respond to CMS's
proposed NCD.

I have used coronary CT angiography for 2 years to
care for patients according to guidelines
published by the American College of Cardiology. I
am a cardiologist    More...



Commenter: Young, Steve
Title: Director Cardiology/Radiology
Date: 01/08/2008
Comment:

In my opinion this policy is too restrictive and
does not taken into account the benefits of
rapid access to CT technology for patients
presenting to the ED with chest pain and
shortness of breath. The new rule does not seem
to   More...



Commenter: YUPPA M.D., FRANK
Date: 01/12/2008
Comment:

THIS ACT IS CRIMINAL.I HAVE SAVED MORE LIVES IN
THE PAST YEAR, THAN I HAVE IN THE PAST 22 YEARS
WITH THE OTHER 5 SUBSPECIALTIES PUT TOGETHER.
APPARENTLY CMS HAS ONCE AGAIN NOT DONE THEIR
HOMEWORK. THEY WILL HAVE THE PRICE OF MANY <   More...



Commenter: Zarnegar, Kousha
Date: 12/24/2007
Comment:

There appears to be a large number of comments
from sources highly invested in the technology of
Coronary CTA considered worthy of attention by
CMS. The manufacturers admit selling the
equipment to perform studies that have not bee   More...



Commenter: Zase, Darlene
Date: 01/12/2008
Comment:

CMS finds itself in a dilemma between
technological advancement and fiscal
responsibility.

I am the CEO of a 20-person radiology group in
Connecticut. We have been performing Coronary
CTA (CCTA) in our practice on a stric   More...



Commenter: Zeck, Lelsie
Date: 01/11/2008
Comment:

CMS, in its memo, proposes a narrowly defined
Coverage with Evidence Development (CED) for CCTA
for limited, inappropriately restrictive
indications and strict research study protocols
that must be submitted, reviewed and approved    More...



Commenter: Zollars, Laurel
Date: 01/10/2008
Comment:

CTA of the coronary arteries is a huge advance
for the public. Rather than getting an arterial
puncture for a catheter case requiring paperwork
admissions through same day surgery and waiting
for several hours post procedure or ha   More...



Commenter: Zoloto, David
Title: Staff Cardiologist
Organization: Colorado Permanente Medical Group
Date: 01/12/2008
Comment:

I am greatly disappointed by the recent CMS NCD
proposal regarding coronary CT angiography.
While the goals of the proposal (presumably to
avoid runaway imaging costs) are laudable, the
authors have unfortunately missed their mark.   More...



Commenter: Zrimec, Gary
Title: CEO
Organization: North Ohio Heart Center
Date: 01/11/2008
Comment:

CCTA is a recognized diagnostic modality that
provides patients a substantial benefit for many
that will be able to avoid a cardiac cath, also
resulting in lower costs for Medicare. CMS is way
off base on their approach, and I supp   More...



Commenter: Zucker MD., Marshall
Date: 01/08/2008
Comment:

As a medical doctor, specialty radiology, I know first-hand about over utilization. However,Medicare should add one more indication for payment for coronary CTA; those patients who have false positives and false negatives concerning both nuclear a   More...



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