Advanced Cardiac Imaging Consortium closing in February 2014

As of Feb, 1, 2014, we will retire the Advanced Cardiac Imaging Consortium, sponsored by Blue Cross Blue Shield of Michigan and Blue Care Network.

Over the last seven years, the ACIC collaborative quality initiative has made a significant impact on the cardiac imaging community. At the state, regional and national levels, it has stimulated radiation dose reduction and appropriate use of coronary CT angiography.

We take tremendous pride in the accomplishments of the collaborative. Each participating facility is to be commended for their contribution towards reaching the goals of the ACIC. Among their accomplishments:

• The demonstration of a 77 percent reduction in radiation dose associated with CCTA over the past seven years
• A 60 percent decrease in inappropriate use of CCTA

Transition to closure
During the coming months, the Blues and the ACIC Coordinating Center will be winding down their activities. Through Jan. 31, 2014, CCTA procedures will continue to be reimbursed at current ACIC CQI participating facilities. 

Effective Feb.1, 2014, the requirement to participate in the ACIC will be eliminated. Keep the following requirements in mind:

• CCTA procedures performed in outpatient settings (excluding the emergency room) will require an approved prior authorization for reimbursement. Blue Cross and BCN use the same prior authorization criteria for these services. For Blue Cross members, visit aimspecialtyhealth.com or call 1-800-728-8008.

• For BCN members, providers may submit requests for clinical review for CCTA procedures to BCN electronically. Users will be prompted to complete an appropriateness questionnaire for clinical review consideration. If the criteria are met, the request will be automatically approved. If the criteria are not met, the request will require further clinical review. Health care providers may also contact BCN’s Care Management department at 1-800-392-2512 to request clinical review. 

These requirements impact procedure codes *75572 through *75574.

If you have any questions, contact your provider consultant.