Radiology Coding Alert

Question: Are there codes for cardiac scoring? I am not familiar with this service, and our radiologists want to begin providing it.

Kentucky Subscriber

Answer: Cardiac scoring is also called coronary calcium screening or ultrafast CT screening, and is still considered investigational. A chest CT is taken while the patient undergoes EKG monitoring to calculate the amount of calcium in the heart. It is typically performed as a screening procedure.

There is no CPT code to describe this service, although some radiology coders are assigning 76499 (unlisted diagnostic radiologic procedure). Medicare is not reimbursing for the procedure, but coders report that a few third-party insurers are. Although unusual, a number of practices say their payers are requesting that 78499 (unlisted cardiovascular procedure, diagnostic nuclear medicine) be reported.

Some coders have also said they assign 71250 (computerized axial tomography, thorax; without contrast material), but this is a potential misrepresentation of the service.

Most practices require that patients sign a waiver and pay in advance for cardiac scoring services because they are generally performed as a screening procedure.