How To Use CPT Code 0626T

CPT 0626T describes the process of automated quantification and characterization of coronary atherosclerotic plaque using data from coronary computed tomographic angiography (CTA). This article will cover the official description, procedure, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information, and examples of CPT code 0626T.

1. What is CPT Code 0626T?

CPT 0626T can be used to report the work involved in reviewing computerized analysis of data from coronary CTA, reconciling discordant data, and completing an interpretation and report. This service helps assess the severity of a patient’s coronary disease by providing quantitative information about coronary stenosis, which is the narrowing of blood vessels due to the deposit of plaques on the inner walls.

2. Official Description

The official description of CPT code 0626T is: ‘Automated quantification and characterization of coronary atherosclerotic plaque to assess severity of coronary disease, using data from coronary computed tomographic angiography; review of computerized analysis output to reconcile discordant data, interpretation and report.’

3. Procedure

1. The process begins with the acquisition of coronary CTA data, which involves injecting dye during CT scanning to produce images of the blood vessels.
2. Specialized software then performs automatic quantitative analysis of the data, providing information such as lesion length, plaque volumes, and plaque type.
3. A qualified healthcare professional reviews the computerized analysis output and reconciles any discordant data.
4. The healthcare professional then interprets the results and prepares a detailed report.

4. Qualifying circumstances

CPT 0626T is appropriate when there is a need to assess the severity of coronary disease using coronary CTA data. This code should be used when the healthcare professional performs the review, reconciliation, interpretation, and report generation based on the computerized analysis output. It is important to note that CPT code 0623T should not be reported in conjunction with 0626T.

5. When to use CPT code 0626T

CPT code 0626T should be used when a healthcare professional reviews computerized analysis output from coronary CTA, reconciles any discordant data, and provides an interpretation and report. This code represents the work involved in these specific tasks and should be reported only once per coronary CTA. It is important to follow the coding guidelines and not report 0623T in conjunction with 0626T.

6. Documentation requirements

To support a claim for CPT code 0626T, the healthcare professional must document the following information:

• Patient’s diagnosis and the need for coronary disease assessment
• Details of the computerized analysis output reviewed
• Date and time of the review and reconciliation
• Interpretation of the data and findings
• Preparation of a comprehensive report
• Signature of the healthcare professional performing the review and interpretation

7. Billing guidelines

When billing for CPT code 0626T, ensure that the healthcare professional has performed the review, reconciliation, interpretation, and report generation based on the computerized analysis output from coronary CTA. It is important to follow the coding guidelines and not report 0623T in conjunction with 0626T. Additionally, do not report 0626T in conjunction with 76376 or 76377.

8. Historical information

CPT code 0626T was added to the Current Procedural Terminology system on January 1, 2021. There have been no updates to the code since its addition.

9. Examples

1. A cardiologist reviewing computerized analysis output from coronary CTA, reconciling discordant data, and preparing an interpretation and report for a patient with suspected coronary disease.
2. A radiologist analyzing coronary CTA data, reconciling any discrepancies, and providing an interpretation and report for a patient with known coronary artery disease.
3. An interventional cardiologist reviewing computerized analysis output from coronary CTA, reconciling discordant data, and generating a comprehensive report for a patient being considered for coronary artery bypass graft surgery.
4. A cardiovascular surgeon interpreting coronary CTA data, reconciling any conflicting information, and preparing a detailed report for a patient with suspected coronary artery disease.
5. A cardiac imaging specialist reviewing computerized analysis output from coronary CTA, reconciling discordant data, and providing an interpretation and report for a patient with a history of myocardial infarction.
6. A cardiovascular researcher analyzing coronary CTA data, reconciling any discrepancies, and generating a comprehensive report for a study on the severity of coronary disease in a specific population.
7. A nuclear medicine physician reviewing computerized analysis output from coronary CTA, reconciling discordant data, and preparing an interpretation and report for a patient undergoing preoperative evaluation for cardiac surgery.
8. A cardiac electrophysiologist interpreting coronary CTA data, reconciling any conflicting information, and providing a detailed report for a patient with arrhythmias and suspected coronary artery disease.
9. A cardiovascular technologist reviewing computerized analysis output from coronary CTA, reconciling discordant data, and generating an interpretation and report for a patient participating in a clinical trial for a new coronary disease treatment.
10. A cardiac nurse practitioner analyzing coronary CTA data, reconciling any discrepancies, and preparing a comprehensive report for a patient with multiple risk factors for coronary artery disease.