The American Medical Association (AMA) has released four new Category I Current Procedural Terminology (CPT) codes to report cardiac CT (CCT) and cardiac CT angiography (CCTA) exams.
The new codes, effective Jan. 1, 2010, are the result of several years of efforts by the American College of Cardiology (ACC), the Society of Cardiovascular CT (SCCT), the American Society of Nuclear Cardiology (ASNC), the American College of Radiology (ACR), North American Society of Cardiovascular Imaging (NASCI) and other members of a multispecialty society collaboration.
In 2008, multispecialty societies requested the conversion of the original codes to Category I code status, wrote Shawn Farley, director of public affairs at ACR, in an email. The reason, Farley wrote, was because "these studies had reached a level of stability in their performance, and it could be shown that they would have an impact on clinical decision making and have a defined place in the medical armamentarium. In place of the eight Category III codes, four new Category I codes (75571-75574) were approved by the AMA CPT Editorial Panel, and will be available for use in 2010."
Set to replace current Category III CPT codes, the new Category I CPT codes describe the CCT/CCTA procedures most frequently used. They include:
- Calcium Scoring--CT (75571): Heart without contrast material with quantitative evaluation of coronary calcium, replacing 0144T. Do not use with 75572-4.
- Pulmonary Veins --CT (75572): Heart with contrast material, for evaluation of cardiac structure and morphology (including 3D image post-processing, assessment of cardiac function and evaluation of venous structures, if performed). Replaces 0145T.
- Congenital Heart Disease --CT (75573): Heart with contrast material, for evaluation of cardiac structure and morphology in the setting of congenital heart disease (including 3D image post-processing, assessment of cardiac LV function, RV structure and function and evaluation of venous structures, if performed). Replaces 0150T.
- CCTA--CT (75574): Heart, coronary arteries and bypass grafts (when present), with contrast material, including 3D image post-processing (including evaluation of cardiac structure and morphology, assessment of cardiac function and evaluation of venous structures, if performed). Replaces 0146T-0149T.
The Centers for Medicare & Medicaid Services (CMS) will likely assign the new CCT/CCTA Category I codes in similar Ambulatory Patient Classification (APC) groupings when the final Hospital Outpatient Prospective Payment System (HOPPS) rule is released in November, according to the Reston, Va.-based ACR.
The ACR suggested that hospitals should consider the costs and work levels associated with each new procedure code and develop representative charges, not simply transfer Category III “T” code payment rates to the new codes.
Due to likely changes in practice expense, malpractice values and equipment utilization rate assumptions, payment rates to be assigned to the new CCT/CCTA codes are at present unknown.
The ACR said it will alert members to this information as soon as it is available. Details regarding these code changes, as well as other changes specific to radiology, will be available Oct. 27 on the ACR Web site.