ACRAD44 –  Comprehensive Reporting of Coronary Artery Calcification (CAC) on Chest CT

Measure Title: Comprehensive Reporting of Coronary Artery Calcification (CAC) on Chest CT

Measure Description: Percentage of final reports for any chest CT examinations (non-cardiac, with or without contrast) performed on patients, aged 18 and older, that:
1. Document the presence or absence of coronary artery calcification (CAC),
2. If CAC is present, include documentation of a qualitative visual assessment of CAC and a recommendation that the patient consult with their primary care clinician for a comprehensive cardiovascular risk assessment, or a quantitative ordinal assessment of CAC for each of the four main coronary arteries. Recommendations for cardiovascular risk assessment should accompany any non-zero score.

Denominator: All final reports for patients aged 18 years or older, undergoing non-cardiac chest CT with or without contrast.

Numerator: Final reports that document:
1. The presence or absence of coronary artery calcification (CAC).
2. If CAC is present, either.
– A qualitative visual assessment of CAC and a recommendation that the patient consult with their primary care clinician for a comprehensive cardiovascular risk assessment, OR
– A quantitative ordinal assessment of CAC for each of the four main coronary arteries. Recommendations for cardiovascular risk assessment should accompany any non-zero score.

Denominator Exclusions: Patients who have received prior coronary artery bypass grafts or prior percutaneous coronary intervention with stent; patients with known CAD; trauma or intraoperative CTs.

Denominator Exceptions: Instances when anatomical variability, patient positioning, or motion artifact prevent CAC detection and/or visual assessment. Studies may be removed from the denominator when the interpreting radiologist determines that CAC assessment is not feasible or appropriate due to image quality or clinical context, including post-contrast exams where diagnostic confidence is insufficient.

Numerator Exclusions: None

CBE ID Number: N/A

High-Priority Measure: Yes

High-Priority Type: Care Coordination

Measure Type: Process

Care Setting: Ambulatory; Hospital Inpatient; Hospital Outpatient; Imaging Facility

Includes Telehealth?: No

Inverse Measure: No

Proportional Measure: Yes

Continuous Variable Measure: No

Ratio Measure: No

Number of performance rates to be calculated and submitted: 1

Risk-Adjusted Status: No

MIPS Reporting Options: Traditional MIPS