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The individuals who appear are for illustrative purposes. All persons depicted are models and not real healthcare professionals. US-N/A-2400043 05/24

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Coding for a non-contrast CT of the heart with calcium scoring

Q.

I am seeing an APC payment assignment for CPT® 75571 (CT coronary scoring), however, Wisconsin Physicians Service (WPS) Billing and Coding article A57552 states that this procedure is non-covered. Why would Medicare assign an APC if it was a non-covered procedure? Is this an error?

A.

Medicare occasionally assigns payment amounts for non-covered services because they know that other payers use their RVUs or payment systems as a basis for payment. Medicare has always included payment information for CPT code 75571. Some Medicare contractors may cover CPT code 75571 if it is not performed as a screening exam. 

The code and full description are as follows:

75571   Computed tomography, heart, without contrast material, with quantitative evaluation of coronary calcium