The nation’s largest commercial health insurer has updated its payment policies and recently began reimbursing for coronary CT angiography as a “first line” test to assess stable chest pain.
United Healthcare said the update took effect on April 1 and applies to its policyholders with low or intermediate risk of coronary artery disease. Imaging advocates applauded the decision this month.
“The favorable policy update shows that United Healthcare recognizes the accumulating evidence demonstrating coronary CTA’s ability to accurately diagnose both nonobstructive and obstructive CAD, as well as lead to improved patient outcomes,” Ron Blankstein MD, president of the Society of Cardiovascular Computed Tomography and an associate professor of radiology at Harvard, said in a statement issued May 12.
United said it expects CT angiography to replace other functional stress tests, such as PET or echocardiogram, in this patient population. In its announcement, the Society of Cardiovascular CT said these changes will make it easier for providers to offer coronary CTA to qualifying patients prior to such stress tests. As part of this process, physicians will be prompted to, instead, use CTA. Those who accept will receive automatic approval from United, while those who insist on a stress test must go through the normal prior authorization process.
The health insurance giant shared steps on requesting such clearance, along with CPT codes, in this announcement.