Current Procedural Terminology (CPT) codes are a standardized language used across the United States healthcare system to describe medical services and procedures performed by physicians and other healthcare providers. Created by the American Medical Association (AMA), these numerical descriptors ensure consistency in documentation and billing for insurers and government payers. CPT 75574 is a highly specific code designated for an advanced, non-invasive imaging procedure that visualizes the coronary arteries of the heart. The code identifies a service requiring specialized equipment and detailed analysis.
Defining Cardiac CT Angiography
CPT 75574 describes Coronary Computed Tomography Angiography (CCTA), which uses advanced X-ray technology to produce detailed, three-dimensional images of the heart and its blood vessels. This diagnostic technique is fundamentally non-invasive, offering a significant advantage over traditional catheter-based angiography. The CCTA procedure involves the intravenous injection of a contrast material, which travels through the bloodstream and opacifies the coronary arteries, making them highly visible on the CT scan images.
The CT scanner rapidly acquires multiple cross-sectional images as the patient lies on a table, often synchronized with the patient’s heartbeat using an electrocardiogram (ECG). These slices are processed by powerful computer software to reconstruct a high-resolution, three-dimensional model of the heart. This model allows physicians to examine the native coronary arteries for signs of narrowing or blockages caused by plaque buildup. The code description explicitly includes the evaluation of existing coronary artery bypass grafts, providing a comprehensive assessment of the heart’s blood supply system.
When Doctors Use This Diagnostic Tool
Physicians order CCTA primarily to evaluate patients presenting with signs or symptoms suggesting Coronary Artery Disease (CAD). The test is frequently used for individuals experiencing chest pain, especially when other non-invasive tests have been inconclusive or difficult to perform. It provides an excellent method to rule out significant coronary artery stenosis, or narrowing, in patients considered to have an intermediate risk for CAD. CCTA has emerged as a valuable alternative to traditional stress testing for patients who are unable to exercise or who have non-diagnostic results from other functional tests.
The high-resolution images are also utilized to evaluate the patency, or openness, of coronary artery bypass grafts in patients who have previously undergone heart surgery. Recurrent symptoms can prompt the need for CCTA to quickly identify if a graft is failing or narrowing without resorting to a more invasive procedure. Additionally, the test is indicated for assessing structural heart abnormalities, such as congenital anomalies of the coronary arteries. In select cases, the procedure assists in pre-operative planning for complex interventions by providing a detailed map of the surrounding anatomy.
Technical Requirements and Billing Specifics of CPT 75574
The assignment of CPT 75574 requires the Coronary CT Angiography to be performed on specialized, high-performance equipment. To achieve the necessary image quality for accurate coronary artery assessment, the procedure must use a multi-detector CT scanner, typically one capable of 64 or more detector rows. This technical requirement is necessary because the heart is a constantly moving organ, and rapid data acquisition effectively “freezes” the motion to produce clear, diagnostic images.
Billing for CPT 75574 is generally handled as a “global code,” meaning the reimbursement covers the entire service, including the technical aspects and the professional interpretation. The technical component encompasses the use of the CT equipment, supplies, contrast material, and the work performed by technologists during acquisition. The professional component covers the radiologist or cardiologist’s expertise in reviewing the images, performing the complex 3D image postprocessing, and writing the final diagnostic report. When the facility and the interpreting physician bill separately, modifier TC is appended for the technical component, and modifier 26 is used for the professional component. The CPT code description states that 3D image postprocessing is included in 75574 and cannot be billed separately under other codes.