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Radiology Coding Alert

You Be the Coder:

Code CTA the Right Way

Published on Mon Mar 27, 2006

Question: Is CPT 71275 (CT angiography, chest) the appropriate code for cardiac CTA?


Missouri Subscriber


Answer: You should not report 71275 (CT angiography, chest) for cardiac CTA. CPT introduced Category III codes 0144T-0151T to describe cardiac CT and CTA specifically, so you should report these codes, depending on the services you provide. (See the list at right.)

Caution: If your payer will reimburse you for 71270 but not the Category III codes, fight the temptation to report 71270 just to get paid, or you could face fines and paybacks. (Find Category III codes listed at www.ama-assn.org/ama/pub/category/3885.html.)

Some payers may consider cardiac CTA medically necessary under certain circumstances.

Example: Empire Medicare has a policy for the Northeast that says indications include "patient with chest pain syndrome (e.g., chest pains, anginal equivalent, angina). Depending on the clinical presentation, the MDCT for coronary artery evaluation may precede a perfusion stress test ..." And you must report a diagnosis supported by the documentation, such as 413.0 (Angina decubitus). (You can see the policy by heading to www.empiremedicare.com/newypolicy/policy/l15934_final.htm.)

Note: The American College of Radiology and the American College of Cardiology worked with providers to develop suggested RVU ranges for these codes. We'll let you know if these are published in a public forum.

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

• 0145T--Computed tomography, heart, without contrast material followed by contrast material(s) and further sections, including cardiac gating and 3D image post processing; cardiac structure and morphology
 
• 0146T--... computed tomographic angiography of coronary arteries (including native and anomalous coronary arteries, coronary bypass grafts), without quantitative evaluation of coronary calcium

• 0147T--... computed tomographic angiography of coronary arteries (including native and anomalous coronary arteries, coronary bypass grafts), with quantitative evaluation of coronary calcium

• 0148T--... cardiac structure and morphology and computed tomographic angiography of coronary arteries (including native and anomalous coronary arteries, coronary bypass grafts), without quantitative evaluation of 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

• 0150T--... cardiac structure and morphology in congenital heart disease

• +0151T--... function evaluation (left and right ventricular function, ejection fraction and segmental wall motion).

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