# Cardiac CT calcium scoring



## Shirleybala (Jun 4, 2009)

Hello:
Can any one guide me to code this report

HISTORY: Abnormal ECG

DESCRIPTION:
Nuclear Imaging:
Following the intravenous administration of 7.3 mCi of
Technetium-99m sestamibi with the patient at rest, tomographic
images of the heart were obtained. Subsequently during peak
treadmill exercise, the patient received an additional intravenous
dose of 21.7 mCi of Technetium-99m sestamibi, and additional
tomographic images were performed. The patient achieved a peak
heart rate of 157 beats per minute which is 96% of predicted
maximum heart rate and a maximal blood pressure of 170/90 mm Hg.
The patient experienced no chest pain, and no ST segment changes
were noted in EKG.

Cardiac CT:
In addition, contiguous axial images of the heart were obtained on
a multidetector CT with suspended respiration. Images were
transferred to a Vitrea workstation for display and quantification
of coronary artery calcification.

FINDINGS:
Nuclear Scan:
No fixed or reversible defects are apparent.
Gated tomographic images show no left ventricular wall motion
abnormalities with a left ventricular ejection fraction of 53%.

Calcium scoring:

LM: 0 
LAD: 0
CFX: 0
RCA: 0
Total calcium score = 0

IMPRESSION: 
1. Normal resting and exercise SPECT sestamibi myocardial
perfusion examination.

2. Coronary calcium score of 0 is consistent with no identifiable
plaque with a very low risk of coronary artery disease.

3. The combined nuclear and CT findings are consistent with very
low risk of coronary artery disease and no hemodynamically
significant coronary stenosis.


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## Joe_coder07 (Jun 4, 2009)

Hi,

My suggestion the following codes can be coded - 0144T for CT heart coronary calcium score, 78465 spect multiple studies , 78478 for wall motion, 78480 for ejection fraction.

Regds,
Joseph Amalraj Antonisamy CPC-H


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## ciphermed (Jun 4, 2009)

Code also for the cardiovascular stress test for the treadmill exercise portion with a code from *93015-95018 *as appropriate, in addition to the TC-99 m Sestamibi A9500 if appropriate for your setting.

Hope this helps,


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## terryjhaney (Jun 4, 2009)

*Agree*

I agree with the coding scenario offered by the previous replies. Good luck getting paid for 0144T, however.


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