Does Medicare cover the cost of a CT angiogram
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Medicare






Does Medicare cover the cost of a CT angiogram

Yes, Medicare does cover the cost of a CT-angiogram in certain clinical conditions.  In order to be covered by medicare, you will need to bring a referral from your physician to the imaging center where your scan is completed.  The list below describes the conditions that constitute "medical necessity."  If you have one of these conditions, medicare will cover the cost of your scan.

Conditions Covered by Medicare

ICD-9 codes are provided as guides to coding of care which is in itself clinically reasonable and necessary. For more information about these conditions and whether you qualify for a CT scan, please speak with your physician


411.1    INTERMEDIATE CORONARY SYNDROME
412    OLD MYOCARDIAL INFARCTION
413.0    ANGINA DECUBITUS
413.1    PRINZMETAL ANGINA
413.9    OTHER AND UNSPECIFIED ANGINA PECTORIS
414.00 - 414.07 CORONARY ATHEROSCLEROSIS OF UNSPECIFIED TYPE OF VESSEL NATIVE OR GRAFT - CORONARY ATHEROSCLEROSIS OF BYPASS GRAFT (ARTERY) (VEIN) OF TRANSPLANTED HEART
414.10 - 414.12 ANEURYSM OF HEART (WALL) - DISSECTION OF CORONARY ARTERY
414.19    OTHER ANEURYSM OF HEART
414.8    OTHER SPECIFIED FORMS OF CHRONIC ISCHEMIC HEART DISEASE
414.9    CHRONIC ISCHEMIC HEART DISEASE UNSPECIFIED
416.0    PRIMARY PULMONARY HYPERTENSION
416.1    KYPHOSCOLIOTIC HEART DISEASE
416.8    OTHER CHRONIC PULMONARY HEART DISEASES
416.9    CHRONIC PULMONARY HEART DISEASE UNSPECIFIED
417.0    ARTERIOVENOUS FISTULA OF PULMONARY VESSELS
417.1    ANEURYSM OF PULMONARY ARTERY
417.8    OTHER SPECIFIED DISEASES OF PULMONARY CIRCULATION
417.9    UNSPECIFIED DISEASE OF PULMONARY CIRCULATION
424.0    MITRAL VALVE DISORDERS
424.1    AORTIC VALVE DISORDERS
425.0 - 425.5 ENDOMYOCARDIAL FIBROSIS - ALCOHOLIC CARDIOMYOPATHY
425.7 - 425.9 NUTRITIONAL AND METABOLIC CARDIOMYOPATHY - SECONDARY CARDIOMYOPATHY UNSPECIFIED
426.10 - 426.13 ATRIOVENTRICULAR BLOCK UNSPECIFIED - OTHER SECOND DEGREE ATRIOVENTRICULAR BLOCK
426.2 - 426.4 LEFT BUNDLE BRANCH HEMIBLOCK - RIGHT BUNDLE BRANCH BLOCK
426.50 - 426.54 BUNDLE BRANCH BLOCK UNSPECIFIED - TRIFASCICULAR BLOCK
426.6    OTHER HEART BLOCK
426.7    ANOMALOUS ATRIOVENTRICULAR EXCITATION
426.81    LOWN-GANONG-LEVINE SYNDROME
426.89    OTHER SPECIFIED CONDUCTION DISORDERS
426.9    CONDUCTION DISORDER UNSPECIFIED
427.0 - 427.2 PAROXYSMAL SUPRAVENTRICULAR TACHYCARDIA - PAROXYSMAL TACHYCARDIA UNSPECIFIED
427.31    ATRIAL FIBRILLATION
427.32    ATRIAL FLUTTER
427.41    VENTRICULAR FIBRILLATION
427.42    VENTRICULAR FLUTTER
427.5    CARDIAC ARREST
427.60    PREMATURE BEATS UNSPECIFIED
427.61    SUPRAVENTRICULAR PREMATURE BEATS
427.69    OTHER PREMATURE BEATS
427.81    SINOATRIAL NODE DYSFUNCTION
427.89    OTHER SPECIFIED CARDIAC DYSRHYTHMIAS
427.9    CARDIAC DYSRHYTHMIA UNSPECIFIED
428.0    CONGESTIVE HEART FAILURE UNSPECIFIED
428.1    LEFT HEART FAILURE
428.20 - 428.23 UNSPECIFIED SYSTOLIC HEART FAILURE - ACUTE ON CHRONIC SYSTOLIC HEART FAILURE
428.30 - 428.33 UNSPECIFIED DIASTOLIC HEART FAILURE - ACUTE ON CHRONIC DIASTOLIC HEART FAILURE
428.40 - 428.43 UNSPECIFIED COMBINED SYSTOLIC AND DIASTOLIC HEART FAILURE - ACUTE ON CHRONIC COMBINED SYSTOLIC AND DIASTOLIC HEART FAILURE
428.9    HEART FAILURE UNSPECIFIED
429.2    CARDIOVASCULAR DISEASE UNSPECIFIED
429.3    CARDIOMEGALY
435.2    SUBCLAVIAN STEAL SYNDROME
440.0    ATHEROSCLEROSIS OF AORTA
441.00    DISSECTION OF AORTA ANEURYSM UNSPECIFIED SITE
441.01    DISSECTION OF AORTA THORACIC
444.1    EMBOLISM AND THROMBOSIS OF THORACIC AORTA
745.10 - 745.12 COMPLETE TRANSPOSITION OF GREAT VESSELS - CORRECTED TRANSPOSITION OF GREAT VESSELS
745.19    OTHER TRANSPOSITION OF GREAT VESSELS
745.2 - 745.5 TETRALOGY OF FALLOT - OSTIUM SECUNDUM TYPE ATRIAL SEPTAL DEFECT
745.60    ENDOCARDIAL CUSHION DEFECT UNSPECIFIED TYPE
745.61    OSTIUM PRIMUM DEFECT
745.69    OTHER ENDOCARDIAL CUSHION DEFECTS
745.7 - 745.9 COR BILOCULARE - UNSPECIFIED DEFECT OF SEPTAL CLOSURE
746.00 - 746.02 CONGENITAL PULMONARY VALVE ANOMALY UNSPECIFIED - STENOSIS OF PULMONARY VALVE CONGENITAL
746.09    OTHER CONGENITAL ANOMALIES OF PULMONARY VALVE
746.1 - 746.7 TRICUSPID ATRESIA AND STENOSIS CONGENITAL - HYPOPLASTIC LEFT HEART SYNDROME
746.81 - 746.87 SUBAORTIC STENOSIS CONGENITAL - MALPOSITION OF HEART AND CARDIAC APEX
746.89    OTHER SPECIFIED CONGENITAL ANOMALIES OF HEART
746.9    UNSPECIFIED CONGENITAL ANOMALY OF HEART
747.0    PATENT DUCTUS ARTERIOSUS
747.10    COARCTATION OF AORTA (PREDUCTAL) (POSTDUCTAL)
747.11    INTERRUPTION OF AORTIC ARCH
747.20 - 747.22 CONGENITAL ANOMALY OF AORTA UNSPECIFIED - CONGENITAL ATRESIA AND STENOSIS OF AORTA
747.29    OTHER CONGENITAL ANOMALIES OF AORTA
747.3    CONGENITAL ANOMALIES OF PULMONARY ARTERY
747.40 - 747.42 CONGENITAL ANOMALY OF GREAT VEINS UNSPECIFIED - PARTIAL ANOMALOUS PULMONARY VENOUS CONNECTION
747.49    OTHER ANOMALIES OF GREAT VEINS
786.05    SHORTNESS OF BREATH
786.50    UNSPECIFIED CHEST PAIN
786.51    PRECORDIAL PAIN
786.59    OTHER CHEST PAIN
794.30    UNSPECIFIED ABNORMAL FUNCTION STUDY OF CARDIOVASCULAR SYSTEM
794.31    NONSPECIFIC ABNORMAL ELECTROCARDIOGRAM (ECG) (EKG)
996.02    MECHANICAL COMPLICATION DUE TO HEART VALVE PROSTHESIS
996.03    MECHANICAL COMPLICATION DUE TO CORONARY BYPASS GRAFT
996.1    MECHANICAL COMPLICATION OF OTHER VASCULAR DEVICE IMPLANT AND GRAFT
V42.1    HEART REPLACED BY TRANSPLANT
V42.2    HEART VALVE REPLACED BY TRANSPLANT
V45.81    POSTSURGICAL AORTOCORONARY BYPASS STATUS





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