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In January 2018, this code was moved to Guideline Note 173. CPT 93895 Carotid intima media thickness Last reviewed at VbBS in November 2014. Minutes indicate that the staff recommendation was accepted without significant discussion. HERC approved the recommendations without change. Definition: Carotid intima-media thickness testing (CIMT or IMT) is an ultrasound-based test to determine the thickness of the intima and media, part of the carotid artery wall. This thickness can be related to prediction of risk for cardiovascular disease. This test requires a high-resolution B-mode ultrasound, which currently is only available in specialized centersEvidenceUSPSTF 2009, review of non-traditional risk factors for screening for cardiovascular diseaseFair-quality evidence indicates, on the basis of 1 fair and 2 good-quality population-based longitudinal studies in the United States and the Netherlands, that carotid IMT predicts CHD independent of Framingham risk factors in asymptomatic persons (1300 to 16 000 men and women who showed a relative risk of 1.19 to 3.80). Adding carotid IMT scores to a risk prediction equation based on traditional risk factors modestly improved the prediction of subsequent CHD among healthy adults, particularly for me. However, the studies that show an association of carotid IMT with CHD outcome have all been done in research settings, and the ability to conduct carotid IMT with precision in nonresearch settings has not been established. No information is available about the prevalence or applicability of carotid IMT to populations at intermediate risk for CHD events.Lack of consensus on examination techniques and population-based standards for interpreting quantitative IMT measures.Overall strength of evidence for prediction of CVD events by use of IMT was rated as poorEffects on treatment decisions based on IMT independent of LDL levels unclearUsefulness of IMT in cardiac risk assessment needs to be validated in prospective, population-based cohort studies that use appropriate methods to measure other risk factors and examine the added predictive ability of carotid IMT in persons classified as intermediate-risk by the Framingham risk score.Recommendation: The USPSTF concludes that the current evidence is insufficient to assess the balance of benefits and harms of using the nontraditional risk factors (includes IMT) studied to screen asymptomatic men and women with no history of CHD to prevent CHD events. (I statement).Goff 2013, ACC/AHA Guideline on the Assessment of Cardiovascular RiskRoutine measurement of CIMT is not recommended in clinical practice for risk assessment for a first ASCVD event.NHLBI Grade: N (No recommendation for or against); ACC/AHA COR III: No Benefit, LOE: BHERC staff recommendation: Non-covered ListUSPSTF and ACC/AHA recommend against use in clinical practice ................
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