Wiki Radiology Coding Question- CTA/Calcium Scoring Coding Question

[shihtzuaddict71]

There are instances where our providers are performing all aspects of CPT 75574 EXCEPT for the angiography. This cannot be performed due to the patient having severe underlying coronary artery calcification:

History: Abnormal Echo
Technique: 3D volumetric acquisition through the heart was obtained without contrast. Images were obtained with retrospective cardiac gating. 3-D post processing was performed on independent workstation. Contrast was not performed due to the patient having severe underlying coronary artery calcification.

The report notes findings of cardiac chambers, Calcium scoring, coronary arteries and Aorta.


What CPT code(s) would you use to code this? 75574-52?

 

[TatyanaNegovan]

You are correct about 75571.
"CPT code 75571 is a Category 1 CPT code that describes a non-contrast computed tomography (CT) scan of the heart with calcium scoring. It should only be used when calcium scoring is performed as a stand-alone procedure. For example, it can be used to report a preliminary scan that shows too much calcium, which may require the original study to be stopped."
Modifier 52 may not be necessary.

 

[shihtzuaddict71]

You are correct about 75571.
"CPT code 75571 is a Category 1 CPT code that describes a non-contrast computed tomography (CT) scan of the heart with calcium scoring. It should only be used when calcium scoring is performed as a stand-alone procedure. For example, it can be used to report a preliminary scan that shows too much calcium, which may require the original study to be stopped."
Modifier 52 may not be necessary.

So you would code this as 75571 and not 75574-52?

 

[TatyanaNegovan]

Yes. This is very common issue on our side. Cardiologists, when we query them on clarification, their rational is the patient is new and we have to proceed with the complete CCTA exam, but documentation and indication for the service do not support CCTA, only 75571. Medicare, and BCBS payors would not pay 75574 in this case.