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