For the Week of October 24, 2016

We are considering doing cardiac CTAs (computed tomography angiography). I am a little confused on the coding. Can you help me understand the difference in the codes? We will be administering a beta blocker during the exam. Can that be reported separately?

Code 75571 is for cardiac scoring only, and it is generally not reimbursed by Medicare and definitely not if it is a screening exam.

Code 75572 is CT of the heart, generally done prior to surgery. It includes evaluation of the pulmonary vein ostia (i.e., prior to atrial fibrillation ablation).

Code 75573 is the same as 75572, except that it is done in the context of congenital heart disease.

Code 75574 is a CTA of the heart including angiographic evaluation of the arteries and grafts.

Codes 75572–75574 include cardiac scoring if done. Do not report both 75571 and one of the other codes.

Check your Medicare Administrative Contractor’s (MAC’s) website for a local coverage determination (LCD) for these exams, including coverage and technology requirements.

The administration of beta-blockers and/or other medications and the monitoring of the patient by a physician during the CTA are not separately billable. However, you should report HCPCS codes for the intravenous contrast material and the beta-blocker.