HCA Probe Reignites Questions Over Interventional Appropriateness

In Maryland, where two cardiologists were convicted in 2011 of having billed Medicare out of hundreds of thousands of dollars for unnecessary interventional procedures, the American College of Cardiology and the Society of Coronary Angiography are working to develop a program to conduct peer review for cardiologists and certification of catheterization labs.

Fonarow says he feels certain that today, most interventional procedures are done in patients who present with acute symptoms: they are having a heart attack and many will die unless a blockage is removed quickly.

"It is generally accepted that lesions that are less than 70%, unless there are mitigating circumstances, and certainly less than 50%, and which do not cause symptoms and aren't limiting flow... should not be intervened upon," he says.