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...

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...

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...

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...

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...

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...

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...

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...

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.

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...

• 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...

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...

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

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...

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...

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...

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.

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...

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...

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...

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...

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...

Please reconsider and stop the proposed cut for
cardiac CT.

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...

• 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...

(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...

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...

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...

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...

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...

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...

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...

(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...

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...

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...

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...

• 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...

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...

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...

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...

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...

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...

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...

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...

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...

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...

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...

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...

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...

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...

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...

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?

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...

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...

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...

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...

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...

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...

• 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...

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...

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...

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...

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...

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.

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!

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...

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...

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...

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...

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...

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...

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

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...

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...

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...

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...

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...

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...

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...

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...

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...

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...

• 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...

• 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...

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...

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...

• 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...

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...

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...

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...

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...

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...

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...

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...

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.

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

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...

• 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...

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...

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...

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...

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...

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...

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

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...

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...

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...

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...

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.

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...

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...

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...

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

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...

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...

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...

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...

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...

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...

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...

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...

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...

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.

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...

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...

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...

• 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...

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...

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...

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.

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...

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...

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...

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...

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...

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

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...

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...

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...

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

• 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...

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...

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...

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...

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...

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...

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...

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...

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.

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.

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...

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...

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...

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...

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...

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...

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...

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...

• 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...

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...

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...

• 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...

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...

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...

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...

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...

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...

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...

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...

• 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...

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...

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...

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...

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...

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...

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...

• 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...

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...

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...

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...

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...

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...

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...

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...

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...

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...

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...

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...

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.

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...

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...

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...

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...

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...

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...

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...

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...

• 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...

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...

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...

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...

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...

• 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...

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...

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...

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...

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...

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...

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...

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...

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...

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...

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...

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...

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...

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...

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...

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...

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...

• 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...

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...

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...

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...

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...

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...

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...

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...

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...

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...

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...

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...

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...

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...

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...

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...

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...

• 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...

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...

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...

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...

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...

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...

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...

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...

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...

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...

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...

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...

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...

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...

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...

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...

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...

• 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...

• 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...

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...