LCD/NCD Portal

L28768 COMPUTED TOMOGRAPHIC ANGIOGRAPHY OF THE CHEST,

HEART AND CORONARY ARTERIES

 

 

10/01/2011

 

 

Indications and Limitations of Coverage and/or Medical Necessity

 

Indications

 

Medicare will consider MDCT angiography of the chest for non-cardiac assessment (71275) medically reasonable and necessary for the following signs or symptoms of disease:

 

• Assessment of a symptomatic patient when presentation is suspicious for pulmonary emboli.

• Abnormalities of the thoracic vasculature such as aortic dissection, aortic aneurysm, pulmonary arterio-venous malformation (AVM) and other abnormalities of the systemic circulation, excluding the heart.

• Assessment of suspected congenital anomalies of the heart or great vessels.

• Assessment of cardiac, mediastinal or lung parenchymal lesions, the vascularity of which is unknown or ill defined, but is critical to the diagnosis.

Medicare will consider MDCT angiography of the chest for cardiac assessment medically reasonable and necessary for the following signs or symptoms of disease:

• Cardiac evaluation of a patient with chest pain syndrome (e.g. anginal equivalent, angina), who is at a low to moderate risk for coronary artery disease (CAD), if use of MDCT is expected to avoid performing diagnostic cardiac catheterization.

o MDCT and coronary angiography are not expected to be performed on the same patient for diagnostic purposes prior to the application of anticipated therapy.

o (If a high pre-test probability of disease exists, as if the patient has known CAD, it is assumed the patient would go to coronary angiography as the definitive test, where possible angioplasty and/or stenting could be performed at the same time).

• Assessment of suspected congenital anomalies of coronary circulation.

• Assessment of symptomatic patients with equivocal stress test results, with or without cardiac imaging, if MDCT is expected to avoid performing diagnostic coronary angiography.

• (Again, if a high pre-test probability of disease exists, as if the patient has known CAD, it is not expected that CT coronary angiography would be done in addition to a subsequent coronary catheterization and angiogram).

• Evaluation of pulmonary veins prior to arrhythmia ablation procedures.

• Evaluation of cardiac veins prior to insertion of biventricular pacemaker.

• Additionally, at times, it may be necessary to evaluate the patient for both cardiac and noncardiac disease.

o Pending the assignment of a code that more precisely describes this service, protocols using cardiovascular CT angiography for the evaluation of acute chest pain in the emergency setting, where pulmonary and/or aortic vascular etiology are also a concern, must be coded with CPT code 71275 only.

o Billing CPT code 71275 plus one of the following CPT codes (75571, 75572, 75573, and 75574) would attest to the fact that two completely separate procedures were performed in their entirety.

Limitations

• The test is never covered for screening, i.e., in the absence of signs, symptoms or disease.

• The test is never covered for patients with stable coronary artery disease without any significant change in signs or symptoms.

• The selection of the test should be made within the context of other testing modalities so that the resulting information facilitates the management decision, and does not merely add an additional layer of testing.

o The test may be denied, on post-pay review, as not medically necessary when used for cardiac evaluation of a patient with extensive disease where there is a pre-test knowledge of extensive calcification that would diminish the interpretive value.

• Coverage of this modality for coronary artery assessment is limited to devices that process thin, high-resolution slices (0.75 mm or less)

o A multidetector scanner must have a row of at least 32 detectors.

o For non-cardiac thoracic assessment, the multidetector scanner may have a capability of less than 16 slices or less.

o The rotational gantry speeds for cardiac evaluation must be 420 milliseconds or less.

• The administration of beta-blockers and/or other medications and the monitoring of the patient by a physician during the MDCT are not separately payable services.

• All studies must be ordered by a physician or a qualified non-physician practitioner.

o A physician or qualified non-physician provider must be present during testing whenever cardioactive agents or contrast agents are administered (direct physician supervision).

o Ideally, this supervising physician will be experienced in this procedure and ACLS-certified.

• Electron Beam Technology provides high temporal resolution and enables quantitative assessment of the coronary artery calcium, but because of limited spatial resolution as a result of the limited z axis resolution (slice thickness=3.0 mm), it does not permit direct visualization in multi-reformation of the whole coronary system.

o Therefore, CT angiography of the heart is not considered medically necessary when performed with an EBT scanner.

• Medicare expects a satisfactory level of competence from providers who submit claims for services rendered.”

• The CMS Manual System, Pub. 100-08, Program Integrity Manual, Chapter 13, Section 5.1 (http://www.cms.hhs.gov/manuals/downloads/pim83c13.pdf outlines that “reasonable and necessary" services are "ordered and/or furnished by qualified personnel."

o Services will be considered medically reasonable and necessary only if performed by appropriately trained providers.

o A qualified physician for this service/procedure is defined as follows:

 Physician is properly enrolled in Medicare.

 Training and expertise must have been acquired within the framework of an accredited residency and/or fellowship program in the applicable specialty/subspecialty in the United States or must reflect equivalent education, training, and expertise endorsed by an academic institution in the United States and/or by the applicable specialty/subspecialty society in the United States.

• The acceptable levels of competence, as defined by the American College of Cardiology ACC/American Heart Association (AHA) Clinical Competence Statement on cardiac imaging with Computed Tomography and Magnetic Resonance (2005) and the American College of Radiology (ACR) Clinical Statement on Noninvasive Cardiac Imaging (2005), are outlined as follows:

o For the technical portion, a recommended level of competence is fulfilled when the image acquisition is obtained under all of the following conditions:

 The service is performed by a radiologic technologist who is credentialed by a nationally recognized credentialing body (American Registry of Radiologic Technologists or equivalent) and meets state licensure requirements where applicable.

 If intravenous beta blockers or nitrates are to be given prior to a CT coronary angiogram or calcium score, the test must be under the direct supervision of a certified registered nurse and physician (familiar with the administration of cardiac medications) who are able to respond to medical emergencies and it is strongly recommended that the certified register nurse and physician be ACLS certified.

 When contrast studies are performed, the physician must provide direct supervision and the radiologic technologist or registered nurse administering the contrast must have appropriate training on the use and administration of contrast media.

o For the professional portion, a recommended level of competence is fulfilled when the interpretation is performed by a physician meeting the following requirements:

 The physician has appropriate additional training in CT Coronary Angiography and cardiac CT imaging equivalent to the guidelines set forth by the ACC or ACR (for example):

• ACCF/AHA Clinical Competence Statement on Cardiac Imaging with Computed Tomography and Magnetic Resonance (2005) and the ACR Clinical Statement on Noninvasive Cardiac Imaging (2005).

• The physician has appropriate medical staff privileges to interpret CT Coronary Angiograms at a hospital that participates in the Medicare program, and is actively training in cardiac CT (as in paragraph a).

• A grace period of 24 months should be allowed to acquire the necessary training.

 

 

Coding Information

 

Bill Type Codes

 

• Contractors may specify Bill Types to help providers identify those Bill Types typically used to report this service.

• Absence of a Bill Type does not guarantee that the policy does not apply to that Bill Type.

• Complete absence of all Bill Types indicates that coverage is not influenced by Bill Type and the policy should be assumed to apply equally to all claims.

 

12x Hospital Inpatient (Medicare Part B only)

13x Hospital Outpatient

85x Critical Access Hospital

 

 

Revenue Codes

 

• Contractors may specify Revenue Codes to help providers identify those Revenue Codes typically used to report this service.

• In most instances Revenue Codes are purely advisory; unless specified in the policy services reported under other Revenue Codes are equally subject to this coverage determination.

• Complete absence of all Revenue Codes indicates that coverage is not influenced by Revenue Code and the policy should be assumed to apply equally to all Revenue Codes.

 

0320 Radiology - Diagnostic - General Classification

0321 Radiology - Diagnostic - Angiocardiology

0322 Radiology - Diagnostic - Arthrography

0323 Radiology - Diagnostic - Arteriography

0324 Radiology - Diagnostic - Chest X-Ray

0329 Radiology - Diagnostic - Other Radiology - Diagnostic

0350 CT Scan - General Classification

0351 CT Scan - CT - Head Scan

0352 CT Scan - CT - Body Scan

0359 CT Scan - CT Other

 

 

CPT/HCPCS Codes

 

71275 COMPUTED TOMOGRAPHIC ANGIOGRAPHY, CHEST (NONCORONARY), WITH CONTRAST MATERIAL(S), INCLUDING NONCONTRAST IMAGES, IF PERFORMED, AND IMAGE POSTPROCESSING

75571 COMPUTED TOMOGRAPHY, HEART, WITHOUT CONTRAST MATERIAL, WITH QUANTITATIVE EVALUATION OF CORONARY CALCIUM

75572 COMPUTED TOMOGRAPHY, HEART, WITH CONTRAST MATERIAL, FOR EVALUATION OF CARDIAC STRUCTURE AND MORPHOLOGY (INCLUDING 3D IMAGE POSTPROCESSING, ASSESSMENT OF CARDIAC FUNCTION, AND EVALUATION OF VENOUS STRUCTURES, IF PERFORMED)

75573 COMPUTED TOMOGRAPHY, HEART, WITH CONTRAST MATERIAL, FOR EVALUATION OF CARDIAC STRUCTURE AND MORPHOLOGY IN THE SETTING OF CONGENITAL HEART DISEASE (INCLUDING 3D IMAGE POSTPROCESSING, ASSESSMENT OF LV CARDIAC FUNCTION, RV STRUCTURE AND FUNCTION AND EVALUATION OF VENOUS STRUCTURES, IF PERFORMED)

75574 COMPUTED TOMOGRAPHIC ANGIOGRAPHY, HEART, CORONARY ARTERIES AND BYPASS GRAFTS (WHEN PRESENT), WITH CONTRAST MATERIAL, INCLUDING 3D IMAGE POSTPROCESSING (INCLUDING EVALUATION OF CARDIAC STRUCTURE AND MORPHOLOGY, ASSESSMENT OF CARDIAC FUNCTION, AND EVALUATION OF VENOUS STRUCTURES, IF PERFORMED)

 

 

ICD-9 Codes that Support Medical Necessity

 

It is not enough to link the procedure code to a correct, payable ICD-9-CM code. The diagnosis or clinical signs/symptoms must be present for the procedure to be paid. Further, these ICD-9-CM codes can be used only with the conditions listed in the Indications and Limitations sections of this LCD.

 

The following codes will be considered reasonable and necessary for CT Angiography of the chest for non-cardiac indications (CPT code 71275):

 

164.1 MALIGNANT NEOPLASM OF HEART

212.7 BENIGN NEOPLASM OF HEART

239.1 NEOPLASM OF UNSPECIFIED NATURE OF RESPIRATORY SYSTEM

337.9 UNSPECIFIED DISORDER OF AUTONOMIC NERVOUS SYSTEM

415.0 ACUTE COR PULMONALE

415.11 IATROGENIC PULMONARY EMBOLISM AND INFARCTION

415.12 SEPTIC PULMONARY EMBOLISM

415.13 SADDLE EMBOLUS OF PULMONARY ARTERY

415.19 OTHER PULMONARY EMBOLISM AND INFARCTION

416.0 PRIMARY PULMONARY HYPERTENSION

416.1 KYPHOSCOLIOTIC HEART DISEASE

416.2 CHRONIC PULMONARY EMBOLISM

416.8 OTHER CHRONIC PULMONARY HEART DISEASES

416.9 CHRONIC PULMONARY HEART DISEASE UNSPECIFIED

417.0 ARTERIOVENOUS FISTULA OF PULMONARY VESSELS

417.1 ANEURYSM OF PULMONARY ARTERY

417.8 OTHER SPECIFIED DISEASES OF PULMONARY CIRCULATION

417.9 UNSPECIFIED DISEASE OF PULMONARY CIRCULATION

435.2 SUBCLAVIAN STEAL SYNDROME

441.00 DISSECTION OF AORTA ANEURYSM UNSPECIFIED SITE

441.01 DISSECTION OF AORTA THORACIC

441.03 DISSECTION OF AORTA THORACOABDOMINAL

441.1 THORACIC ANEURYSM RUPTURED

441.2 THORACIC ANEURYSM WITHOUT RUPTURE

441.6 THORACOABDOMINAL ANEURYSM RUPTURED

441.7 THORACOABDOMINAL ANEURYSM WITHOUT RUPTURE

444.1 EMBOLISM AND THROMBOSIS OF THORACIC AORTA

458.9 HYPOTENSION UNSPECIFIED

518.51 ACUTE RESPIRATORY FAILURE FOLLOWING TRAUMA AND SURGERY

518.52 OTHER PULMONARY INSUFFICIENCY, NOT ELSEWHERE CLASSIFIED, FOLLOWING TRAUMA AND SURGERY

518.53 ACUTE AND CHRONIC RESPIRATORY FAILURE FOLLOWING TRAUMA AND SURGERY

518.81 ACUTE RESPIRATORY FAILURE

518.82 OTHER PULMONARY INSUFFICIENCY NOT ELSEWHERE CLASSIFIED

729.5 PAIN IN LIMB

729.81 SWELLING OF LIMB

747.10 COARCTATION OF AORTA (PREDUCTAL) (POSTDUCTAL)

747.11 INTERRUPTION OF AORTIC ARCH

747.20 CONGENITAL ANOMALY OF AORTA UNSPECIFIED

747.21 CONGENITAL ANOMALIES OF AORTIC ARCH

747.22 CONGENITAL ATRESIA AND STENOSIS OF AORTA

747.29 OTHER CONGENITAL ANOMALIES OF AORTA

747.31 PULMONARY ARTERY COARCTATION AND ATRESIA

747.32 PULMONARY ARTERIOVENOUS MALFORMATION

747.39 OTHER ANOMALIES OF PULMONARY ARTERY AND PULMONARY CIRCULATION

747.40 CONGENITAL ANOMALY OF GREAT VEINS UNSPECIFIED

747.41 TOTAL ANOMALOUS PULMONARY VENOUS CONNECTION

747.42 PARTIAL ANOMALOUS PULMONARY VENOUS CONNECTION

747.49 OTHER ANOMALIES OF GREAT VEINS

748.9 UNSPECIFIED CONGENITAL ANOMALY OF RESPIRATORY SYSTEM

785.0 TACHYCARDIA UNSPECIFIED

785.2 UNDIAGNOSED CARDIAC MURMURS

786.05 SHORTNESS OF BREATH

786.06 TACHYPNEA

786.09 RESPIRATORY ABNORMALITY OTHER

786.30 HEMOPTYSIS, UNSPECIFIED

786.39 OTHER HEMOPTYSIS

786.50 UNSPECIFIED CHEST PAIN

786.51 PRECORDIAL PAIN

786.52 PAINFUL RESPIRATION

786.59 OTHER CHEST PAIN

786.6 SWELLING MASS OR LUMP IN CHEST

794.2 NONSPECIFIC ABNORMAL RESULTS OF FUNCTION STUDY OF PULMONARY SYSTEM

 

The following codes will be considered reasonable and necessary for CT Angiography of the Chest for Cardiac indications for CPT codes 75571, 75572, 75573, 75574.

 

402.00 MALIGNANT HYPERTENSIVE HEART DISEASE WITHOUT HEART FAILURE

402.01 MALIGNANT HYPERTENSIVE HEART DISEASE WITH HEART FAILURE

402.10 BENIGN HYPERTENSIVE HEART DISEASE WITHOUT HEART FAILURE

402.11 BENIGN HYPERTENSIVE HEART DISEASE WITH HEART FAILURE

402.90 UNSPECIFIED HYPERTENSIVE HEART DISEASE WITHOUT HEART FAILURE

402.91 UNSPECIFIED HYPERTENSIVE HEART DISEASE WITH HEART FAILURE

411.1 INTERMEDIATE CORONARY SYNDROME

412 OLD MYOCARDIAL INFARCTION

413.0 ANGINA DECUBITUS

413.1 PRINZMETAL ANGINA

413.9 OTHER AND UNSPECIFIED ANGINA PECTORIS

414.00 CORONARY ATHEROSCLEROSIS OF UNSPECIFIED TYPE OF VESSEL NATIVE OR GRAFT

414.01 CORONARY ATHEROSCLEROSIS OF NATIVE CORONARY ARTERY

414.02 CORONARY ATHEROSCLEROSIS OF AUTOLOGOUS VEIN BYPASS GRAFT

414.03 CORONARY ATHEROSCLEROSIS OF NONAUTOLOGOUS BIOLOGICAL BYPASS GRAFT

414.04 CORONARY ATHEROSCLEROSIS OF ARTERY BYPASS GRAFT

414.05 CORONARY ATHEROSCLEROSIS OF UNSPECIFIED BYPASS GRAFT

414.06 CORONARY ATHEROSCLEROSIS OF NATIVE CORONARY ARTERY OF TRANSPLANTED HEART

414.07 CORONARY ATHEROSCLEROSIS OF BYPASS GRAFT (ARTERY) (VEIN) OF TRANSPLANTED HEART

414.10 ANEURYSM OF HEART (WALL)

414.11 ANEURYSM OF CORONARY VESSELS

414.12 DISSECTION OF CORONARY ARTERY

414.19 OTHER ANEURYSM OF HEART

414.3 CORONARY ATHEROSCLEROSIS DUE TO LIPID RICH PLAQUE

414.4 CORONARY ATHEROSCLEROSIS DUE TO CALCIFIED CORONARY LESION

414.8 OTHER SPECIFIED FORMS OF CHRONIC ISCHEMIC HEART DISEASE

414.9 CHRONIC ISCHEMIC HEART DISEASE UNSPECIFIED

420.0 ACUTE PERICARDITIS IN DISEASES CLASSIFIED ELSEWHERE

420.90 ACUTE PERICARDITIS UNSPECIFIED

420.91 ACUTE IDIOPATHIC PERICARDITIS

420.99 OTHER ACUTE PERICARDITIS

745.0 COMMON TRUNCUS

745.10 COMPLETE TRANSPOSITION OF GREAT VESSELS

745.11 DOUBLE OUTLET RIGHT VENTRICLE

745.12 CORRECTED TRANSPOSITION OF GREAT VESSELS

745.19 OTHER TRANSPOSITION OF GREAT VESSELS

745.2 TETRALOGY OF FALLOT

745.3 COMMON VENTRICLE

745.4 VENTRICULAR SEPTAL DEFECT

745.5 OSTIUM SECUNDUM TYPE ATRIAL SEPTAL DEFECT

745.60 ENDOCARDIAL CUSHION DEFECT UNSPECIFIED TYPE

745.61 OSTIUM PRIMUM DEFECT

745.69 OTHER ENDOCARDIAL CUSHION DEFECTS

745.7 COR BILOCULARE

745.8 OTHER BULBUS CORDIS ANOMALIES AND ANOMALIES OF CARDIAC SEPTAL CLOSURE

745.9 UNSPECIFIED DEFECT OF SEPTAL CLOSURE

746.00 CONGENITAL PULMONARY VALVE ANOMALY UNSPECIFIED

746.01 ATRESIA OF PULMONARY VALVE CONGENITAL

746.02 STENOSIS OF PULMONARY VALVE CONGENITAL

746.09 OTHER CONGENITAL ANOMALIES OF PULMONARY VALVE

746.1 TRICUSPID ATRESIA AND STENOSIS CONGENITAL

746.2 EBSTEIN'S ANOMALY

746.3 CONGENITAL STENOSIS OF AORTIC VALVE

746.4 CONGENITAL INSUFFICIENCY OF AORTIC VALVE

746.5 CONGENITAL MITRAL STENOSIS

746.6 CONGENITAL MITRAL INSUFFICIENCY

746.7 HYPOPLASTIC LEFT HEART SYNDROME

746.81 SUBAORTIC STENOSIS CONGENITAL

746.82 COR TRIATRIATUM

746.83 INFUNDIBULAR PULMONIC STENOSIS CONGENITAL

746.84 CONGENITAL OBSTRUCTIVE ANOMALIES OF HEART NOT ELSEWHERE CLASSIFIED

746.85 CORONARY ARTERY ANOMALY CONGENITAL

746.86 CONGENITAL HEART BLOCK

746.87 MALPOSITION OF HEART AND CARDIAC APEX

746.89 OTHER SPECIFIED CONGENITAL ANOMALIES OF HEART

746.9 UNSPECIFIED CONGENITAL ANOMALY OF HEART

747.40 CONGENITAL ANOMALY OF GREAT VEINS UNSPECIFIED

747.41 TOTAL ANOMALOUS PULMONARY VENOUS CONNECTION

747.42 PARTIAL ANOMALOUS PULMONARY VENOUS CONNECTION

747.49 OTHER ANOMALIES OF GREAT VEINS

786.05 SHORTNESS OF BREATH

786.50 UNSPECIFIED CHEST PAIN

786.51 PRECORDIAL PAIN

786.59 OTHER CHEST PAIN

794.30 UNSPECIFIED ABNORMAL FUNCTION STUDY OF CARDIOVASCULAR SYSTEM

794.31 NONSPECIFIC ABNORMAL ELECTROCARDIOGRAM (ECG) (EKG)

 

 

Documentation Requirements

 

• The documentation of the study requires a formal written report, with clear identifying demographics, the name of the interpreting provider, reason for the test, an interpretive report and copies of images.

o The computerized data with image reconstruction should also be maintained.

• The medical record must contain documentation that fully supports the medical necessity of the procedure performed.

o This documentation includes, but is not limited to relevant medical history, physical examination, and results of pertinent diagnostic tests or procedures.

o This entire documentation- not just the test report or the finding /diagnosis on the order- must be available to Medicare upon request.

Treatment Logic

• Multislice or Multidetector Computed Tomography (MDCT) angiography with its advanced spatial and temporal resolution has opened up new possibilities in the imaging of the major vessels of the chest, including aorta, pulmonary arteries, and coronary arteries.

• MDCT technology for cardiac and coronary artery assessment requires thin (less than 1 mm) slices, 0.5 to 0.75 mm reconstructions, multiple simultaneous images (e.g. 40-64 or more slices) and cardiac gating (often requiring beta blockers for ideal heart rate).

o There is significant post processing, depending on the number of slices for image generation.

o For coronary artery imaging, the resulting images show a high correlation with stenotic lesions noted on diagnostic cardiac catheterization but more importantly, with atheromas on intracoronary ultrasound.

o Additionally, the technique may be helpful in defining the vascularity of chest or lung lesions.

 

 

Sources of Information and Basis for Decision

 

ACC/AHA Clinical Competence statement on Cardiac Imaging with Computed Tomography and Magnetic Resonance (2005) Journal of the American College of Cardiology. 46 (2) 383-402.

 

ACR Practice Guideline for the performance and interpretation of CT angiography (CTA).

 

American Medical Association. Clinical Examples in Radiology. 2 (1).

 

American Society of Cardiology Foundation. (2006). Task force 12: Training in Advanced Cardiovascular imaging (Computed Tomography). Journal of the American College of Cardiology. 47 (4).

 

Budoff, M., Achenbach, S., Duerinckx, A. (2003). Clinical utility of computed tomography and magnetic resonance techniques for noninvasive coronary angiography. Journal of the American College of Cardiology.42 (11): 1867-78.

 

FCSO LCD 29117, Computed Tomographic Angiography of the Chest, Heart and Coronary Arteries, 10/01/2011. The official local coverage determination (LCD) is the version on the Medicare coverage database at www.cms.gov/medicare-coverage-database/.

 

Funabashi, N., Kobayashi, Y., Perlroth, M., Rubin, G.D. (2003). Coronary artery: quantitative evaluation of normal diameter determined with electron-beam CT compared with cine coronary angiography-initial experience. Radiology. 226:263-271.

 

Giacomo, L., Cademartiri, F., Dake, M.D., Larini, P., Pavne, P. (2003). Value of three-dimensional reconstructions in evaluating thoracic aortic aneurysms. Images in Cardiovascular Medicine. 107:e34.

 

Gibbons, R.J., Eckel, R. H., & Jacobs, A. K. (2006). The utilization of cardiac imaging. Retrieved on April 11, 2006 from Circulation online at: http://www.circulatonaha.org.

 

Hoffman, M.H., Schmitz, B.L., Lieberknecht, M, Schulze, R., Ludwig, B., Kroschel, U., Jahnke, N., Haerer, W., Brambs, H., Aschoff, A.J. (2005). Noninvasive coronary angiography with multislice computed tomography. JAMA. 293: 2471-2478.

 

Kuettner, A., Schroeder, S., Feyer, A., Beck, T., Brueckner, A., Heuschmid, M., Burgstahler, C., Kopp, A., F., & Claussen, C.D. (2004). Noninvasive detection of coronary lesions using 16-detector multislice spiral computed tomography technology: initial clinical results. Journal of American College of Cardiology, 44:1230-1237.

 

Model Local Coverage determination (LCD) workgroup for cardiac Computed Tomography and Computed Tomography Coronary Angiography (CTCA). (2005).

 

Mollet, N.R., Niemanm K., Lemos, P.A., Pattynama, P.M., Serruys, P.W., Krestin, G.P., deFeyter, P.J. (2004). Multislice spiral computed tomography coronary angiography in patients with stable angina pectoris. Journal of the American College of Cardiology. 43:2265-2270.

 

North Carolina LCD for Computed Tomographic Angiography of the Chest, Heart and Coronary Arteries.

 

Qaseem, A., Snow, V., Barry, P., Hornblake, E., Rodnick, J., Tobolic, T. & et al. (2007). Current diagnosis of venous thromboembolism in primary care: a clinical practice guideline from the American Academy of Family Physicians and the American College of Physicians. Annals of Family Medicine. 5, (1).

 

Sato, Y., Matsumoto, N., Kato, M., & et.al. (2003). Noninvasive assessment of coronary artery disease by multislice spiral computed tomography using a new retrospectively ECG-gated image reconstruction technique. Comparison with angiographic results. Circulation Journal. 401-405.

 

Schoenhagen, P., Halliburton, S.S., Stillman, A. E., Nissen, S.E., Tuzcu, E.,M., White, R.D. (2004). Noninvasive imaging of coronary arteries: Current and future role of Multi-detector row CT. Radiology. 2327-17.

 

Schoepf, U.J., Becker, C.R., Ohnesorge, B.M., Yucel, E.K. (2004). CT of coronary artery disease. Radiology.232: 18-37.

 

Singh, J. Houser, S., Heist, E., Ruskin, J. (2005). The coronary venous anatomy: a segmental approach. Journal of American College of Cardiology. 46 (1): 68-74.

 

Stein, P., Woodard, P., Weg, J., Wakefield, T., Tapson, V., Sostman, H. & et al. (2006). Diagnostic pathways in acute pulmonary embolism: recommendations of the PIOPED II investigators. The American Journal of Medicine. 119, 1048-1055.

 

Weinreb, J.C., Larson, P.A., Woodard, P.K., Stanford, W., Rubin, G.D., Stillman, A.E., Bluemke, D.A., Duerincks, A. J., Dunnick, N.R., & Smith, G.C. (2005). American College of Radiology Clinical Statement on Noninvasive Cardiac Imaging. Radiology, 235: 723-727.

 

White, R., Setser, R. (2002). Integrated approach to evaluating coronary artery. The American Journal of Cardiology. 10C:49-55.

 

Yamamuro, M., Tadamura, E., Kubo, S., Toyoda, H., Nishina, T., Ohba, M., Hosokawa, R., Kimura, T., Tamaki, N., Komedam M., Kita, T., & Konishi, J. (2005). Cardiac functional analysis with multi-detector row CT and segmented reconstruction algorithm: comparison with echocardiography, SPECT, and MR imaging. Radiology, 234: 381-390.

 

Yamamuro, M., Tadamura, E., Kubo, S. & et.al. (2005). Cardiac functional analysis with multi-detector row CT and segmental reconstruction algorithm: Comparison with echocardiography, spect, and MR imaging. Radiology. 234:381-390.

 

 

AMA CPT Copyright Statement

CPT codes, descriptions and other data only are copyright 2011 American Medical Association (or such other date of publication of CPT). All Rights Reserved. Applicable FARS/DFARS Clauses Apply.

 

 

CMS LCD COMPUTED TOMOGRAPHIC ANGIOGRAPHY OF THE CHEST, HEART AND CORONARY ARTERIES