Radiology Coding Alert

Question: Our hospital recently purchased a 64-slice CT scanner. Will we have reimbursement beginning in 2007 from Medicare for calcium scoring?


Washington Subscriber

Answer: Probably not. Most payers regard calcium scoring as a screening service and will not cover it. That situation is unlikely to change soon.

Heart CT codes with cardiac scoring remain in Category III in 2007:

• 0144T -- Computed tomography, heart, without contrast material, including image postprocessing and quantitative evaluation of coronary calcium

• 0147T -- Computed tomography, heart, without  contrast material followed by contrast material(s) and  further sections, including cardiac gating and 3D image processing; computed tomographic angiography of coronary arteries (including native and anomalous coronary arteries, coronary bypass  grafts), with quantitative evaluation  coronary calcium

• 0149T -- ... cardiac structure and morphology and  computed tomographic angiography of coronary  arteries (including native and anomalous coronary arteries, coronary bypass grafts), with quantitative  evaluation of coronary calcium.

When you only perform calcium scoring, report 0144T (Computed tomography, heart, without contrast material, including image postprocessing and quantitative evaluation of coronary calcium).

Most Medicare carriers do not cover the cardiac CTA codes that include calcium scoring.

The most commonly covered service is exam of the coronary arteries without calcium scoring, reported with 0146T (Computed tomography, heart, without contrast material followed by contrast material[s] and further sections, including cardiac gating and 3D image postprocessing; computed tomographic angiography of coronary arteries [including native and anomalous coronary arteries, coronary bypass grafts], without quantitative evaluation of coronary calcium).

Bottom line: Check your payer's published coverage policies to know for sure.