How To Use CPT Code 75572

CPT 75572 is a computed tomography (CT) procedure used to evaluate cardiac structure and morphology, including 3D image postprocessing, assessment of cardiac function, and evaluation of venous structures, if performed. This article will cover the description, procedure, qualifying circumstances, when to use the code, documentation requirements, billing guidelines, historical information, similar codes, and examples of CPT 75572 procedures.

1. What is CPT 75572?

CPT 75572 is a diagnostic imaging procedure that involves the use of computed tomography (CT) to examine the structure and function of the heart. This procedure includes three-dimensional post-processing, assessments of the functions of the heart, and analyzing the venous structures, if performed. It is used to detect any defects or abnormalities in the heart and helps healthcare providers make informed decisions about the patient’s treatment plan.

2. 75572 CPT code description

The official description of CPT code 75572 is: “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)”.

3. Procedure

1. The patient is prepared for the procedure, which may include administering contrast material and injecting an intravenous medicine to reduce the heart rate and regulate the rhythm of the heart.
2. The patient lies on a table that has a CT machine at the other end.
3. The CT machine takes several cross-sectional images of the heart.
4. The provider analyzes the arterial phase CT images and prescribes and analyzes venous phase images, as necessary.
5. A two-dimensional restoration of the vasculature is established.
6. A three-dimensional restoration of the vessels associated with the myocardium is established.

4. Qualifying circumstances

Patients who are eligible to receive CPT code 75572 services are those who require a detailed evaluation of their cardiac structure and morphology. This may include patients with suspected or known heart abnormalities, such as congenital heart defects, coronary artery disease, or valvular heart disease. Additionally, patients who have experienced symptoms suggestive of a heart condition, such as chest pain, shortness of breath, or palpitations, may also be eligible for this procedure.

5. When to use CPT code 75572

It is appropriate to bill the 75572 CPT code when a healthcare provider performs a computed tomography (CT) scan of the heart with contrast material to evaluate the cardiac structure and morphology. This includes the assessment of cardiac function and the evaluation of venous structures, if performed. The code should be used when the procedure is medically necessary and meets the qualifying circumstances mentioned above.

6. Documentation requirements

To support a claim for CPT 75572, the following information should be documented in the patient’s medical record:

• Indication for the procedure, including the patient’s symptoms and/or medical history that justify the need for the CT scan.
• Details of the procedure, including the administration of contrast material and any medications used to regulate the heart rate and rhythm.
• Findings from the CT scan, including any abnormalities or defects identified in the cardiac structure and morphology.
• Assessment of cardiac function and evaluation of venous structures, if performed.
• Interpretation of the CT images and any recommendations for further evaluation or treatment based on the findings.

7. Billing guidelines

When billing for CPT code 75572, it is important to follow the appropriate guidelines and rules. If you are reporting only the physician’s interpretation for the radiology service, you should append professional component modifier 26 to the radiology code. If you are reporting only the technical component for the radiology service, you would append modifier TC to the radiology code. However, payer policy may exempt hospitals from appending modifier TC because the hospital’s portion is inherently technical. Do not append a professional or technical modifier to the radiology code when reporting a global service in which one provider renders both the professional and technical components.

8. Historical information

CPT 75572 was added to the Current Procedural Terminology system on January 1, 2010. There have been no updates to the code since its addition.

9. Similar codes to CPT 75572

There are several other CPT codes related to cardiac imaging procedures that differentiate from CPT 75572:

1. CPT 75571: This code is used for a cardiac CT scan without contrast material.
2. CPT 75573: This code is used for a cardiac CT scan with coronary calcium scoring.
3. CPT 75574: This code is used for a cardiac CT angiography procedure.
4. CPT 78451: This code is used for a single-photon emission computed tomography (SPECT) myocardial perfusion imaging study.
5. CPT 93306: This code is used for a transthoracic echocardiography procedure with Doppler and color flow imaging.

10. Examples

Here are 10 detailed examples of CPT code 75572 procedures:

1. A patient with a history of chest pain and shortness of breath undergoes a CPT 75572 procedure to evaluate the cardiac structure and morphology.
2. A patient with a known congenital heart defect requires a CPT 75572 procedure to assess the current status of the defect and plan for potential surgical intervention.
3. A patient with suspected coronary artery disease undergoes a CPT 75572 procedure to evaluate the extent of the disease and determine the appropriate treatment plan.
4. A patient with a history of valvular heart disease undergoes a CPT 75572 procedure to assess the function of the heart valves and plan for potential valve replacement surgery.
5. A patient with a family history of cardiomyopathy undergoes a CPT 75572 procedure to evaluate the cardiac structure and function for early detection and intervention.
6. A patient with a history of heart palpitations and syncope undergoes a CPT 75572 procedure to evaluate the cardiac structure and morphology for potential arrhythmogenic substrates.
7. A patient with a history of myocardial infarction undergoes a CPT 75572 procedure to assess the extent of myocardial damage and plan for potential revascularization procedures.
8. A patient with a history of pulmonary hypertension undergoes a CPT 75572 procedure to evaluate the cardiac structure and function for potential right heart dysfunction.
9. A patient with a history of aortic aneurysm undergoes a CPT 75572 procedure to assess the cardiac structure and morphology for potential aortic root involvement.
10. A patient with a history of heart failure undergoes a CPT 75572 procedure to evaluate the cardiac structure and function for potential ventricular remodeling and optimization of medical therapy.