The use of IVUS in transcatheter revascularization therapy of coronary artery disease may be considered medically necessary as a technique of guiding transcatheter revascularization.
Intracoronary ultrasonography is considered for payment, to determine the significance of an intermediate stenosis (40% to 70% obstruction) or to determine the lesion to be revascularized in case of multiple lesions. The great advantage of intracoronary ultrasound is that the clinical significance of stenosis intermedia can be assessed at the time of angiography and treatment not postponed (PTCA or CABG) until performing cardiac function tests.
The IVUS is considered for payment under the following conditions:
When through a pre-angiogram functional test (eg perfusion test cardiac) it is not possible to establish the diagnosis. The use of ultrasound will be required intravascular to determine the degree of obstruction.
When a pre-angiogram functional test is positive for a lesion significant, but that at the time of angiography lesions are found multiple. In this case, intravascular ultrasound would be used to determine which lesion or lesions would proceed to revascularize.
The routine use of intracoronary ultrasound and the concomitant use of Functional tests of the heart*, be they pre or post angiogram will not be considered for payment. *Cardiac perfusion test.
