How To Use CPT Code 75573

CPT 75573 describes the use of computed tomography (CT) with contrast material to evaluate the structure and morphology of the heart in patients with congenital heart disease. This article will cover the description, procedure, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information, similar codes and billing examples.

1. What is CPT Code 75573?

CPT 75573 is a code used to describe the diagnostic procedure of computed tomography (CT) with contrast material for the evaluation of cardiac structure and morphology in patients with congenital heart disease. This procedure includes the use of three-dimensional image postprocessing, assessment of left ventricular (LV) cardiac function, evaluation of right ventricular (RV) structure and function, and assessment of vascular structures if performed.

2. Official Description

The official description of CPT code 75573 is: ‘Computed tomography, heart, with contrast material, for evaluation of cardiac structure and morphology in the setting of congenital heart disease (including 3D image postprocessing, assessment of LV cardiac function, RV structure and function and evaluation of vascular structures, if performed)’

3. Procedure

1. The procedure begins with the provider administering contrast material to the patient to enhance the visibility of the cardiac structures.
2. The patient is positioned on the table of the CT machine, and the machine rotates around the patient to capture cross-sectional images of the heart.
3. The CT scan may include three-dimensional (3D) image postprocessing to further analyze the structure and morphology of the heart.
4. The provider assesses the left ventricular (LV) cardiac function, evaluates the right ventricular (RV) structure and function, and examines vascular structures if necessary.
5. Based on the images and data obtained, the provider interprets the findings and completes a report.

4. Qualifying circumstances

CPT 75573 is used for patients with congenital heart disease who require an evaluation of their cardiac structure and morphology. This procedure is performed to assess the presence of any anomalies or defects in the heart. The use of contrast material allows for better visualization of the cardiac structures. The assessment of LV cardiac function, RV structure and function, and vascular structures is included if performed.

5. When to use CPT code 75573

CPT code 75573 should be used when a patient with congenital heart disease requires a CT scan with contrast material to evaluate their cardiac structure and morphology. This code is appropriate when the provider performs 3D image postprocessing, assesses LV cardiac function, evaluates RV structure and function, and examines vascular structures if necessary. It is important to ensure that the patient meets the criteria for congenital heart disease and that the procedure is medically necessary.

6. Documentation requirements

To support a claim for CPT 75573, the provider must document the following information:

• Patient’s diagnosis of congenital heart disease
• Reason for performing the CT scan with contrast material
• Date of the procedure
• Details of the contrast material administered
• Specific findings and interpretations of the cardiac structure and morphology
• Assessment of LV cardiac function, RV structure and function, and evaluation of vascular structures if performed
• Signature of the provider

7. Billing guidelines

When billing for CPT 75573, ensure that the procedure meets the criteria for congenital heart disease evaluation. It is important to use the appropriate diagnosis code to support medical necessity. If only the physician’s interpretation is being reported, append modifier 26 to the radiology code. If only the technical component is being reported, append modifier TC to the radiology code. However, be aware that payer policies may exempt hospitals from appending modifier TC. It is crucial to review payer guidelines and follow proper coding and billing practices.

8. Historical information

CPT 75573 was added to the Current Procedural Terminology system on January 1, 2010. The code was later revised on January 1, 2022, to include the evaluation of venous structures if performed.

9. Examples

1. A patient with congenital heart disease undergoes a CT scan with contrast material to evaluate the structure and morphology of their heart, including the assessment of LV cardiac function and RV structure and function.
2. A provider performs a CT scan with contrast material on a patient with congenital heart disease to assess the vascular structures of their heart, in addition to evaluating the cardiac structure and morphology.
3. A CT scan with contrast material is performed on a patient with congenital heart disease to evaluate the structure and morphology of their heart, including the assessment of LV cardiac function and RV structure and function, as well as the evaluation of venous structures.
4. A provider uses CT with contrast material to evaluate the structure and morphology of the heart in a patient with congenital heart disease, focusing on the assessment of LV cardiac function and RV structure and function.
5. In a patient with congenital heart disease, a CT scan with contrast material is performed to assess the vascular structures of the heart, along with the evaluation of cardiac structure and morphology, including the assessment of LV cardiac function and RV structure and function.