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Correct coding for CTAs of different body areas, including heart and chest

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Q.

Our radiologists perform computed tomographic angiography (CTAs) for pre-transcatheter aortic valve replacement (TAVR) imaging the heart, chest, abdomen, and pelvis. Currently, we are billing these exams with CTA heart and CTA abdomen and pelvis CPT® 75574 and 74174. May we assign a code for the CTA Chest (CPT 71275) as well?

A.

You need to ask the tech or doctor to see if separate CTA heart and CTA chest were done or were the chest images seen during the cardiac CTA. When an exam is done, all body areas seen must be documented/interpreted. So, if a cardiac CTA was performed, and the doctor documented the non-heart chest images as a CTA chest, then you can only code a cardiac CTA. In addition, there are now protocols that allow one scan to cover heart and chest – that would also just be reported as one scan, either chest or cardiac.