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Criteria for Coronary Artery Calcium Scoring by Computed Tomography

Initiated: 7/16
Reviewed: 1/17
Revised:

 

Coronary artery calcium (CAC) scoring is a test that is noninvasive and is used for cardiovascular risk assessment by measuring the location and extent of calcium in the coronary arteries. In general it is a better marker of the extent of coronary atherosclerosis than the severity of stenosis. 

 

Coronary artery calcium scoring by computed tomography is considered medically necessary for cardiovascular risk assessment in the following:   

  1. Asymptomatic persons with an intermediate (10% to 20%) 10-year risk of cardiac events based on Framingham Risk Scoring or Pooled Cohort Equations.
  2. Measurement of CAC may be reasonable for cardiovascular risk assessment in persons at low to intermediate risk (6% to 10% 10-year risk).
  3. Asymptomatic persons age 40 years and older with diabetes. 

Coronary Artery Calcium Scoring may not be useful/ effective under the following circumstances: 

  1. In patients at low (<10 percent, 10 year risk) or high (>20 percent, 10-year) CHD risk as established by the Framingham risk score and modified Framingham / ATP risk scores.
  2. As a measure to establish the presence of obstructive disease for subsequent revascularization.
  3. Serial or repeat calcium scoring is not recommended as it is considered experimental and investigational.

ConnectCare

Utilization Management

ConnectCare's Utilization Management Staff is available to address questions and issues related to case management and utilization by using the telephone or fax numbers listed below.

ConnectCare Medical Management
4000 Wellness Drive
Midland, MI 48670
Toll free: 888-646-2429
Local: 989-839-1613
Fax: 989-839-1679
 
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