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86 Multislice CT in Coronary Heart Disease KCE Reports 82 As far as the limited duration of the trial, and consequently the economic model, is concerned, we know from the clinical literature review that the prognosis of patients who present with atypical chest pain is generally good. Early intervention in patients with CAD but no documented ischemia diagnosed by MSCT angiography does not necessarily improve long-term outcomes in these patients. The cost estimates in our base-case analysis only included direct health care costs. Indirect costs from productivity losses were not valued. In the RCT, more patients in the MSCT arm underwent revascularisation than in the standard of care arm. Revascularisation requires hospitalisation for, on average, 3 to 7 (PCI) or 13 to 18 (CABG) days in Belgium.(https://tct.fgov.be/etct/anonymous?lang=nl; visited on April 10, 2008) This would imply higher indirect costs associated with MSCT. As it was already clear from the direct cost calculation that MSCT is more expensive than standard of care, indirect costs would only add to the cost difference between MSCT and standard of care. This is a qualitative conclusion that can be drawn, without having to quantify the precise impact on productivity.
KCE Reports 82 Multislice CT in Coronary Heart Disease 87 APPENDIX TO CHAPTER 6 Table 26: USA CPT codes to report cardiac CT including MSCT coronary angiography (revision 1 st January 2008) Code Name of procedure Short descriptor 0144T Computed tomography, heart, without contrast material, including image post-processing and quantitative evaluation of coronary calcium Calcium scoring 0145T Computed tomography, heart, with contrast material(s), including Cardiac morphology noncontrast images, if performed, cardiac gating and 3D image postprocessing; cardiac structure and morphology only 0146T Computed tomography, heart, with contrast material(s), including noncontrast images, if performed, cardiac gating and 3D image postprocessing; computed tomographic angiography of coronaryarteries (Including native and anomalous coronary arteries, coronary bypass grafts), without quantitative evaluation of coronary calcium Coronaries only 0147T Computed tomography, heart, with contrast material(s), including Coronaries and noncontrast images, if performed, cardiac gating and 3D image postprocessing; computed tomographic angiography of coronary arteries (Including native and anomalous coronary arteries, coronary bypass grafts), with quantitative evaluation of coronary calcium calcium scoring 0148T Computed tomography, heart, with contrast material(s), including Coronaries and noncontrast images, if performed, cardiac gating and 3D image postprocessing; cardiac structure and morphology and computed tomographic angiography of coronary arteries (including native and anomalous coronary arteries, coronary bypass grafts), without quantitative evaluation of coronary calcium cardiac morphology 0149T Computed tomography, heart, with contrast material(s), including Coronaries, calcium noncontrast images, if performed, cardiac gating and 3D image scoring and cardiac postprocessing; cardiac structure and morphology and computed tomographic angiography of coronary arteries (including native and anomalous coronary arteries, coronary bypass grafts), with quantitative evaluation of coronary calcium morphology 0150T computed tomography, heart, without contrast material followed by congenital studies, contrast material(s) and further sections, including cardiac gating and 3D image post processing; cardiac structure and morphology in congenital heart disease non-coronary +0151T +computed tomography, heart, without contrast material followed by +RVEF/LVEF and wall contrast material(s) and further sections, including cardiac gating and motion (add on 3D image post processing; function evaluation (left and right ventricular function, ejection fraction and segmental wall motion) code) Only one of these codes may be reported at the time except code 0151T that may be added to codes 0144T-0151T
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