2025 CPT code 75571
(Active) Effective Date: N/A Revision Date: N/A Diagnostic Imaging - Cardiac Computed Tomography Radiology Feed
Computed tomography of the heart without contrast, quantifying coronary artery calcium.
Modifier 26 (professional component) may be appended if the physician only interprets the study. Modifier TC (technical component) may be appended if only the technical component is billed (though hospital settings may have different policies).
Medical necessity is established when the physician orders this test to assess the risk of coronary artery disease, particularly in patients with multiple risk factors or a family history of the disease. The results help guide preventive measures and treatment decisions. Some payers require explicit justification, usually tied to specific risk factors and clinical context.
The clinical responsibility lies with the radiologist who interprets the images and reports the quantitative coronary calcium score.This includes ensuring the technical aspects of the scan are adequately performed and the results are accurately interpreted and reported to the referring physician.
In simple words: This test uses a CT scan (like an X-ray) to measure calcium buildup in your heart's arteries.It doesn't use any dye and helps doctors see how much calcium is present, which can indicate a risk of heart problems.
This CPT code encompasses a non-contrast computed tomography (CT) scan of the heart, specifically designed for the quantitative assessment of coronary artery calcium. The procedure involves the acquisition and analysis of cross-sectional images to determine the amount of calcium deposits within the coronary arteries. This evaluation aids in the assessment of coronary artery disease risk.
Example 1: A 55-year-old male patient with a family history of heart disease undergoes a coronary calcium score assessment as part of a preventative health screening.The results are used to assess his risk of future cardiovascular events., A 60-year-old female patient presents with chest pain and elevated cardiac enzymes.A non-contrast CT scan (75571) is performed to rule out significant coronary artery calcification as a potential cause of her symptoms, before proceeding with a contrast enhanced cardiac CT scan if needed., A 40-year-old asymptomatic patient with multiple risk factors for coronary artery disease (CAD) undergoes a coronary calcium scan (75571) to stratify their risk for CAD and to guide preventive interventions.
The minimum documentation should include:
** The Agatston score is the standard method for quantifying coronary artery calcium.The interpretation of the calcium score should always be considered within the patient's clinical context and other risk factors.Documentation should include clear correlation with the clinical scenario and relevant risk factors.
- Payment Status: Active
- Modifier TC rule: Modifier TC is applicable when only the technical component of the study is billed.This is typically done by facilities.
- Specialties:Cardiology, Radiology
- Place of Service:Office, Outpatient Hospital, Ambulatory Surgical Center