Recalculate How You Should Report CCTA Codes -- Your Bottom Line Will Thank You
Published on Mon Aug 06, 2007
Find out what your cardiologist needs to document to substantiate your claim If you've got coronary computed tomographic angiography (CCTA) questions, we've got answers. Check out this breakdown of what codes 0144T-0151T represent, how you should report them, and whether carriers are starting to pay for these procedures. "Because the application of CT imaging for the purpose of coronary and cardiac purposes is relatively new, we are witnessing an evolution of the related reimbursement issues: the code structure, coverage guidelines, provider credential requirements, reimbursement rates, and over-read protocols," according to the April 2007 Cardiology Coalition Membership Newsletter. Why CCTA is worthwhile: Although CCTA images are slightly less accurate than images obtained from catheter-based angiographic studies (heart catheterization), CCTA is a desirable diagnostic testing modality.-This is because it is much less invasive than heart catheterization, requiring only an injection of contrast and possibly a medication to help lower the patient's heart rate. Consequently, CCTA has replaced and will continue to replace many diagnostic heart catheterizations.- See How You Should Report CCTAs In the past: When you reported the work associated with CCTA, you would use either chest CTA code 71275 (Computed tomographic angiography, chest, without contrast material[s], followed by contrast material[s] and further sections, including image postprocessing) or unlisted-procedure code 76497 (Unlisted computed tomography procedure [e.g., diagnostic, interventional]), says Terri Davis, CPC, CIC, a coding supervisor at The University of Oklahoma College of Medicine in Oklahoma City. What you should use now: You should use Category III codes 0144T-0151T, Davis says. You can find these codes in the 2007 CPT manual, just before appendix A.-These codes are temporary, indicating that the AMA considers CCTA an "emerging technology."-Although these codes were effective in January 2006, they did not make their debut in the official CPT book until the 2007 edition. Coverage: Most payers didn't cover CCTA because they deemed it "investigational" technology. Now payers do cover this form of testing for certain symptoms, but you still need to confirm coverage and coding with your individual payers. First, Confront Calcium Scoring The first code in this range, 0144T (Computed tomography, heart, without contrast material, including image postprocessing and quantitative evaluation of coronary calcium), is a diagnostic test that measures the amount of calcium that has built up in coronary arteries.- What calcium is: Calcium is a mineral that circulates throughout the body and is necessary for many cellular functions, including bone strength. Calcium is frequently deposited in arterial walls, where it stiffens the blood vessels and causes them to harden.-This calcium buildup contributes to the formation of plaque and the eventual blockage of blood flow.- Did you know? Because calcium is a marker of coronary disease, many physicians use calcium scoring to predict [...]
