CurrentBlue Cross Blue Shield - Rhode IslandPolicy N/A

Medical Coverage Policy: Cardiointegram (CIG) / Omnicardiogram

Policy governs coverage determination for Cardiointegram (CIG)/Omnicardiogram as a diagnostic technique to detect ECG abnormalities for Commercial products of Blue Cross & Blue Shield of Rhode Island. Medicare Advantage members are referred to related Medicare policies.

Policy Summary

PayerBlue Cross Blue Shield - Rhode Island

PolicyCardiointegram (CIG) / Omnicardiogram coverage

Policy CodePolicy N/A

Change TypeNo material change

Effective DateFeb 6, 2010

Next Review DateN/A

Key ActionDo not submit claims for Cardiointegram (HCPCS S9025) for Commercial members; it is considered not medically necessary and may be denied.

SourceLink

POLICY UPDATE CHANGES

No material clinical or coverage changes in this revision.

Not medically necessarycoverage stance

S9025specific code

Commercial onlyplan applicability

2022-07-20last update

Coverage Determination

Not Medically Necessary

Coverage determination for Commercial Products

Main coverage stance: Cardiointegram (Omnicardiogram) is considered NOT MEDICALLY NECESSARY for Commercial Products because the evidence is insufficient to determine its effect on health outcomes.

May be proposed as a substitute for exercise tolerance testing with thallium imaging, but inadequately validated.

This policy applies to Commercial Products only. For members enrolled in Medicare Advantage plans, coverage is determined according to applicable Medicare national or local coverage determinations; see the Related Policies section for guidance.

Cardiointegram (CIG) / Omnicardiogram is considered not medically necessary for Commercial Products due to insufficient evidence demonstrating an effect on health outcomes. The following HCPCS code is listed as not medically necessary: S9025 (Omnicardiogram / cardiointegram).

Coding and Billing

Not Medically Necessary CodesHCPCSNot Covered

S9025

Omnicardiogram / cardiointegram

Policy Summary

PayerBlue Cross Blue Shield - Rhode Island

PolicyCardiointegram (CIG) / Omnicardiogram coverage

Policy CodePolicy N/A

Change TypeNo material change

Effective DateFeb 6, 2010

Next Review DateN/A

Key ActionDo not submit claims for Cardiointegram (HCPCS S9025) for Commercial members; it is considered not medically necessary and may be denied.

SourceLink

On This Page

Trek Health ingests and normalizes Transparency in Coverage data and payer policy updates to give provider organizations a clear view of how commercial reimbursement behaves across markets, payers, and services. Our platform transforms raw payer disclosures into structured intelligence that supports contract evaluation, payer negotiations, and service line strategy. By combining market benchmarks with ongoing policy visibility, Trek helps teams identify variability, risk, and opportunity in commercial reimbursement. The result is faster insight, stronger negotiating positions, and more informed financial decisions.

Provider Requirements and Next Steps

Note

Prior Authorization

Prior authorization is not applicable for this policy.

Note

Member Benefits and Eligibility

Verify member-specific benefits and eligibility prior to providing services. Benefits and eligibility are determined by the member's subscriber agreement, member certificate, and/or the employer agreement; those documents supersede this medical policy. For member-specific benefit information, contact the provider call center. If services are determined to be not medically necessary or are non-covered, providers may not bill the member unless the member has been informed in advance and has agreed in writing to pay at their own expense. Refer to your provider participation agreement for applicable provisions.

Denial Risk

Denial Risk for Cardiointegram

Claims for Cardiointegram/Omnicardiogram (S9025) for Commercial Products are considered not medically necessary and may be denied.

S9025 — Omnicardiogram / Cardiointegram

Definitions

Cardiointegram (CIG) / Omnicardiogram — device/technique definition

TermCardiointegram (CIG) / Omnicardiogram

DefinitionA microcomputer-based device/technique that receives output from a standard 12-lead electrocardiogram (EKG) and transforms it into graphic representations of heart electrophysiologic signals.

Intended useIntended to detect electrophysiologic abnormalities not identifiable by routine 12-lead ECG interpretation; proposed as a substitute for exercise tolerance testing with thallium imaging in select patients.

LimitationsConsidered not medically necessary due to insufficient evidence to support its efficacy as a diagnostic tool for cardiac ischemia.

Clinical contextUsed when resting EKG may be inadequate to identify changes compatible with coronary artery disease.

OpenPayer

Medical Coverage Policy: Cardiointegram (CIG) / Omnicardiogram

Coverage Determination

Coding and Billing

Provider Requirements and Next Steps

Background

Definitions