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Computed tomography (CT) using either spiral (helical) CT, electron beam CT (EBCT), or multi-detector CT (MDCT) can be used as a method for detecting coronary artery calcification. The CT scan allows automated quantification of the total size and density of the calcium deposits, which is reported as a calcium score. The coronary artery calcium score is used as a predictor of future risk of coronary artery disease and in the diagnosis of coronary artery disease in symptomatic patients.
Spiral CT, EBCT, and MDCT have faster scan times than conventional CT. Spiral CT is performed as the patient is transported continuously through the scanner and the scan device rotates around the patient in a corkscrew-like path. Modifying the spiral scanning technique by gating image acquisition to the electrocardiogram allows only those frames acquired during diastole to be utilized for analysis of coronary calcium. This has enabled the use of more readily available spiral scanners for the determination of a calcium score. MDCT uses multiple rows of detectors that spiral around the patient simultaneously during a rapid volumetric image acquisition. The current generation of MDCT scanners generally has at least 64 detector rows.
EBCT, also known as ultrafast CT, bounces a single, focused beam of electrons off a series of tungsten targets arrayed around the patient to acquire serial transaxial images of the heart and coronary arteries. Three-dimensional reconstructions of the coronary vasculature can be created. EBCT and MDCT were initially the primary fast CT methods for measurement of coronary artery calcification. More recently, CT angiography has been used to assess coronary calcium.
For applicable clinical criteria, see the following eviCore clinical guideline:
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Note that services with specific coverage criteria may be reviewed retrospectively to determine if criteria are being met. Retrospective denial of claims may result if criteria are not met.
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Acknowledgements:
CPT® codes copyright American Medical Association® 2022. All rights reserved.
CDT codes copyright American Dental Association® 2022. All rights reserved.