National Coverage Determination (NCD)

Displacement Cardiography

20.24

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Tracking Information

Publication Number
100-3
Manual Section Number
20.24
Manual Section Title
Displacement Cardiography
Version Number
1
Effective Date of this Version
10/12/1988

Description Information

Benefit Category
Diagnostic Tests (other)


Please 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

A. Cardiokymography

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

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; or
  • For female patients, angina, either typical or atypical.

B. Photokymography - Not Covered

Photokymography remains excluded from coverage.

Transmittal Information

Transmittal Number
33
Revision History

09/1988 - Cardiokymography covered for certain indications. Photokymography remained noncovered. Effective date 10/12/1988. (TN 33)

Additional Information

Other Versions
Title Version Effective Between
Displacement Cardiography 1 10/12/1988 - N/A You are here