NCD20.24 DISPLACEMENT CARDIOGRAPHY

 

 

Effective Date of this Version

10/12/1988

 

 

Benefit Category

 

• Diagnostic Tests (other)

• Note: This may not be an exhaustive list of all applicable Medicare benefit categories for this item or service.

 

 

Item/Service Description

 

• Displacement cardiography, including cardiokymography and photokymography, is a noninvasive diagnostic test used in evaluating coronary artery disease.

 

 

Indications and Limitations of Coverage

 

• Cardiokymography

o Cardiokymography is covered for services rendered on or after October 12, 1988.

o Cardiokymography is a covered service only when it is used as an adjunct to electrocardiographic stress testing in evaluating coronary artery disease and only when the following clinical indications are present:

 For male patients, atypical angina pectoris or nonischemic chest pain.

 For female patients, angina, either typical or atypical.

• Photokymography - Not Covered

o Photokymography remains excluded from coverage.

 

 

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