Medicare Compliance & Reimbursement

If you've ever wondered whether Medicare actually pays attention to CPT's Category III codes, the AMA offers an answer with the release of the new codes included in CPT 2010.

First and foremost, CPT will delete the Category III cardiac computed tomography (CT) imaging codes 0144T-0151T and replace them with new, permanent Category I codes, as follows:

• 75571 -- CT, heart, without contrast material, with quantitative evaluation of coronary calcium

• 75572 -- CT, heart, with contrast material, for evaluation of cardiac structure and morphology (including 3D image postprocessing, assessment of cardiac function, and evaluation of venous structures, if performed)

• 75573 -- CT, heart, with contrast material, for evaluation of cardiac structure and morphology in the setting of congenital heart disease (including 3D image postprocessing, assessment of LV cardiac function, RV structure and function, and evaluation of venous structures, if performed)

• 75574 -- CT angiography, heart, coronary arteries and bypass grafts (when present), with contrast material, including 3D image postprocessing (including evaluation of cardiac structure and morphology, assessment of cardiac function, and evaluation of venous structures, if performed).

CPT 2010 deletes the myocardial perfusion add-on codes +78478 and +78480, despite the fact that coders often leaned on those codes. "Codes +78478 and +78480 are used often in our practice," says Debby Simmons, CPC, with Cumberland Cardiovascular Associates.

"My opinion on this is that they are trying to eliminate the use of multiple codes to describe procedures that are normally performed in one session," Simmons says. "Eliminating these 'add-on codes' saves on keystrokes and space. I don't think the elimination of these codes is due to them not being reported, but for efficiency," she suggests.

And CPT also debuts new code 75565 (Cardiac magnetic resonance imaging for velocity flow mapping [List separately in addition to code for primary procedure]), but deletes all of the previous codes that specified flow/velocity quantification (75558, 75560, 75562, and 75564).