CPT® Code 0691T

Automated analysis of an existing computed tomography study for vertebral fracture(s), including assessment of bone density when performed, data preparation, interpretation, and report

The CPT® Code 0691T refers to an automated analysis of an existing computed tomography (CT) study specifically aimed at evaluating vertebral fractures. This procedure involves a sophisticated method of estimating the strength of vertebrae to assess the risk of fractures. It utilizes finite element analysis (FEA) or volumetric bone density measurements derived from CT images, employing proprietary software designed for this purpose. Vertebral fractures are recognized as the most prevalent type of osteoporotic fracture, and notably, a significant proportion of individuals with such fractures may exhibit normal bone mineral density when evaluated through dual-energy X-ray absorptiometry (DXA). This discrepancy highlights the importance of CT-based FEA, which offers a more reliable means of identifying patients at elevated risk for fractures. The analysis typically focuses on the lumbar vertebrae, where the bone image is meticulously segmented, and voxel intensity values are translated into bone mineral density. The process involves converting the bone volume into 1x1x1mm voxels, each of which is transformed into a hexahedral finite element with specific properties corresponding to the bone mineral density. By applying simulated uniform axial compression in a virtual environment, the strength of the vertebra is determined. Additionally, the same software can assess integral volumetric bone density by calculating the average density across the entire vertebral body, providing a comprehensive evaluation of bone health.