Computed Tomography to Detect Coronary Artery Calcification
© Blue Cross and Blue Shield of Montana
Current Effective Date:
February 01, 2014
Original Effective Date:
December 18, 2009
January 15, 2014
June 1, 2011; May 3, 2012; August 20, 2012; August 21, 2013; January 15, 2014
Electron-beam computed tomography (CT; also known as ultrafast CT) uses an electron gun rather than a standard x-ray tube to generate x-rays, thus permitting very rapid scanning. Spiral CT scanning (also referred to as helical CT scanning) also creates images at greater speeds by rotating a standard x-ray tube around the patient such that data are gathered in a continuous spiral or helix rather than in individual slices.
While both electron-beam CT (EBCT) and spiral computed tomography (CT) scanning may be valued as an alternative to conventional CT scanning due to their faster throughput, their speed of image acquisition also permits unique imaging of the moving heart. For example, the rapid image acquisition time virtually eliminates motion artifact related to cardiac contraction, permitting visualization of the calcium in the epicardial coronary arteries. EBCT software permits quantification of calcium area and density, which are translated into calcium scores. Calcium scores have been investigated as a technique for detecting coronary artery calcification, both as a diagnostic technique in symptomatic patients to rule out an atherosclerotic etiology of symptoms or, in asymptomatic patients, as an adjunctive method for risk stratification for coronary artery disease.
EBCT and multi-detector computed tomography (MDCT) were initially the primary fast CT methods for measurement of coronary artery calcification. A fast CT study for coronary artery calcium measurement generally takes 10 to 15 minutes and requires only a few seconds of scanning time. More recently, CT angiography has been used to assess coronary calcium. Because of the basic similarity between EBCT and CT angiography in measuring coronary calcium, it is expected that CT angiography provides similar information on coronary calcium as does EBCT.
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I25.10-I25.119, I25.700-I25.799, Z13.6
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- Computed Tomography to Detect Coronary Artery Calcification. Chicago, Illinois: Blue Cross Blue Shield Association Medical Policy Reference Manual (2013 June) Radiology: 6.01.03.
||Policy reviewed no changes to policy, rationale, and references updated. Removed 0144T, 0147T, 0149T as these codes were deleted 12/31/2009.|
||Policy updated with literature search. Rationale extensively revised and condensed. References 9, 12, 14-16 added; other references removed. No change in policy statement|
||Policy updated with literature search. References 9, 10, 18, 19 added. No change in policy statement|
||Policy formatting and language revised. Policy statement unchanged. Title changed from "Computed Tomography to Detect Coronary Artery Calcification" to "Cardiac Computed Tomography (CCT) for Calcium Scoring". Removed CPT codes 75572, 75573, and 75574.|
||Document updated with literature review. Coverage unchanged. Title changed from Cardiac Computed Tomography (CCT) for Calcium Scoring. CPT/HCPCS codes updated.|