Cardiology Question for the Week of March 28, 2016

Question:

We need your help in clarifying the use of codes 75572 and 75574. There is a difference of opinion among the coders. 

Are both of these codes for CTA exams: 75572 for a heart exam and 75574 for an exam of the heart and coronary arteries? OR is 75572 a CT of the heart including 3D image postprocessing and 75574 for a CTA of the heart and coronary arteries? Our hospital is doing CCTA exams, which I believe is code 75574.

Answer

Code 75572 is for a CT scan, not a CTA, and it is intended for evaluation of the structures of the heart prior to surgery. (Code 75573 is the same except it is specifically for patients with congenital heart disease.) The clinical examples given for 75572 in CPT Changes and CPT Assistant are for preoperative exams prior to ablation for atrial fibrillation to identify the number, location, and morphology of the pulmonary veins as they enter the left atrium, the contours of the endoluminal surface of the left atrium, and the location of the esophagus in relation to the pulmonary veins.  

Code 75574 is for a CTA, which includes an angiographic evaluation of the arteries and grafts. 

75572 Computed tomography, heart, with contrast material, for evaluation of cardiac structure and morphology (including 3D image postprocessing, assessment of cardiac function, and evaluation of venous structures, if performed)

75574 Computed tomographic angiography, heart, coronary arteries and bypass grafts (when present), with contrast material, including 3D image postprocessing (including evaluation of cardiac structure and morphology, assessment of cardiac function, and evaluation of venous structures, if performed)

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