Cardiology Coding Alert

Question: The cardiologist provided professional interpretation of electron beam tomography (EBT) of the chest. We were advised to use 71250 and 71260. We were also told that Medicare and many other carriers do not pay for this service. Are we using the right codes?

Delaware Subscriber  
Answer: Codes 71250 (computerized axial tomography, thorax; without contrast material) and 71260 ( with contrast material[s]) are correct for chest scans. CPT does not include a code for EBT, however, which typically involves measurement of calcium scoring (often the first sign of atherosclerosis) using an extremely quick CT scan. Therefore, use an unlisted radiology-procedure code.
 
Since few carriers pay for EBT, the patient should be told in advance that this is a cash service. The patient should sign a waiver (although it is not absolutely necessary as usually there is no question that this service is not covered; the waiver lets the patient know in advance that he or she may not be covered), and payment should be received before the service is performed. If the carrier pays for the service, the refund can be sent to the patient.