C7516 Cor angio w/ ivus or oct

Catheter placement in coronary artery(s) for coronary angiography, including intraprocedural injection(s) for coronary angiography, with endoluminal imaging of initial coronary vessel or graft using intravascular ultrasound (ivus) or optical coherence tomography (oct) during diagnostic evaluation and/or therapeutic intervention including imaging supervision, interpretation and report

Medically Unlikely Edits (effective October 1, 2026)

Payer policies and prior authorization for C7516

Payer coverage policies that name C7516

C7516 appears in 3 coverage policies from Aetna, Premera Blue Cross.

PayerPolicyRole in policyReviewedDocument
AetnaIntravascular Optical Coherence Tomography (0829)listed, no stanceApr 27, 2026payer document
AetnaIntravascular Ultrasound (0382)listed, no stanceMay 26, 2026payer document
Premera Blue CrossCoronary Angiography for Known or Suspected Coronary Artery Disease in Adults (2.02.507)listed, no stanceAug 11, 2026payer document

Medicaid fee-for-service

  • AZ: $1492.24 (asc), effective Oct 1, 2026
  • IN: $0.00 (professional, facility), effective Jan 1, 2023
  • KS: $1384.40 (asc, facility), effective Jan 1, 2023
  • KY: $2662.25 (asc), effective Jan 1, 2026
  • MA: $1977.77 (asc), effective May 1, 2026
  • ND: $1569.40 (physician, facility), effective Aug 1, 2026
  • VT: $0.00 (outpatient_hospital_opps), effective Feb 1, 2026
  • WY: $0.00 (outpatient_hospital_apc, Children's Hospitals), effective Apr 1, 2026

From payers' published prior-auth lists, coverage policies and state Medicaid fee schedules, updated Oct 16, 2026. The role is what the policy's own code table or text says about the code. Not a guarantee of coverage or payment; verify with the payer. CPT® is a registered trademark of the American Medical Association.