How To Use CPT Code 75571

CPT 75571 is a computed tomography (CT) scan of the heart without contrast material, used for quantitative evaluation of coronary calcium. 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 75571 procedures.

1. What is CPT 75571?

CPT 75571 is a medical billing code used for computed tomography (CT) scans of the heart without the use of contrast material. This specific code is utilized for the quantitative evaluation of coronary calcium, which helps healthcare providers assess the presence and extent of calcium deposits in the coronary arteries. These deposits can be indicative of coronary artery disease and can help determine a patient’s risk for future cardiac events.

2. 75571 CPT code description

The official description of CPT code 75571 is: “Computed tomography, heart, without contrast material, with quantitative evaluation of coronary calcium.”

3. Procedure

1. The patient is positioned on the CT scanner table, and ECG leads may be attached to their chest to monitor heart activity during the scan.
2. The CT scanner takes multiple cross-sectional images of the heart without the use of contrast material.
3. The images are analyzed to quantify the amount of calcium present in the coronary arteries.
4. The results are used to assess the patient’s risk for coronary artery disease and potential future cardiac events.

4. Qualifying circumstances

Patients eligible to receive CPT code 75571 services are those who have a clinical indication for a non-contrast CT scan of the heart to evaluate coronary calcium. This may include patients with a family history of coronary artery disease, those with risk factors for heart disease, or individuals experiencing symptoms suggestive of coronary artery disease. The decision to perform this test should be based on a thorough evaluation of the patient’s medical history, risk factors, and clinical presentation.

5. When to use CPT code 75571

It is appropriate to bill the 75571 CPT code when a healthcare provider performs a non-contrast CT scan of the heart for the purpose of quantitatively evaluating coronary calcium. This code should be used when the primary goal of the scan is to assess the presence and extent of calcium deposits in the coronary arteries, which can help determine a patient’s risk for future cardiac events.

6. Documentation requirements

To support a claim for CPT 75571, the following information should be documented in the patient’s medical record:

• Indication for the CT scan, including relevant medical history, risk factors, and symptoms
• Details of the procedure, including the use of ECG monitoring if applicable
• Results of the quantitative evaluation of coronary calcium, including the calcium score and any identified areas of calcification
• Interpretation of the results and their implications for the patient’s risk of coronary artery disease and future cardiac events
• Any recommendations for further testing, treatment, or follow-up based on the results of the CT scan

7. Billing guidelines

When billing for CPT code 75571, it is important to follow established billing guidelines and rules. If only the physician’s interpretation of the radiology service is being reported, professional component modifier 26 should be appended to the radiology code. If only the technical component of the radiology service is being reported, modifier TC should be appended to the radiology code. However, payer policy may exempt hospitals from appending modifier TC, as 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 75571 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 75571

Five similar codes to CPT 75571 and how they differ are:

• CPT 75572: This code is used for a CT scan of the heart with contrast material, including 3D image post-processing.
• CPT 75573: This code is for a CT scan of the heart with contrast material for congenital cardiac anomalies, including 3D image post-processing.
• CPT 75574: This code is for a CT angiography of the heart with contrast material, including 3D image post-processing and evaluation of cardiac structure and morphology.
• CPT 71250: This code is for a CT scan of the thorax without contrast material.
• CPT 71260: This code is for a CT scan of the thorax with contrast material.

10. Examples

Here are 10 detailed examples of CPT code 75571 procedures:

1. A 55-year-old male with a family history of coronary artery disease undergoes a non-contrast CT scan of the heart to evaluate coronary calcium.
2. A 60-year-old female with hypertension and hyperlipidemia has a non-contrast CT scan of the heart to assess her risk for coronary artery disease.
3. A 50-year-old male with chest pain and a history of smoking undergoes a non-contrast CT scan of the heart to evaluate coronary calcium.
4. A 65-year-old female with diabetes and a history of angina has a non-contrast CT scan of the heart to assess her risk for future cardiac events.
5. A 45-year-old male with a family history of early-onset coronary artery disease undergoes a non-contrast CT scan of the heart to evaluate coronary calcium.
6. A 70-year-old male with a history of myocardial infarction and coronary artery bypass surgery has a non-contrast CT scan of the heart to assess his risk for future cardiac events.
7. A 40-year-old female with chest pain and a family history of coronary artery disease undergoes a non-contrast CT scan of the heart to evaluate coronary calcium.
8. A 58-year-old male with hypertension, hyperlipidemia, and a history of smoking has a non-contrast CT scan of the heart to assess his risk for coronary artery disease.
9. A 62-year-old female with chest pain and a history of diabetes undergoes a non-contrast CT scan of the heart to evaluate coronary calcium.
10. A 48-year-old male with a family history of early-onset coronary artery disease and a history of smoking has a non-contrast CT scan of the heart to assess his risk for future cardiac events.