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Cardiac CT calcium scoring

  1. Default Cardiac CT calcium scoring
    Medical Coding Books
    Can any one guide me to code this report

    HISTORY: Abnormal ECG

    Nuclear Imaging:
    Following the intravenous administration of 7.3 mCi of
    Technetium-99m sestamibi with the patient at rest, tomographic
    images of the heart were obtained. Subsequently during peak
    treadmill exercise, the patient received an additional intravenous
    dose of 21.7 mCi of Technetium-99m sestamibi, and additional
    tomographic images were performed. The patient achieved a peak
    heart rate of 157 beats per minute which is 96% of predicted
    maximum heart rate and a maximal blood pressure of 170/90 mm Hg.
    The patient experienced no chest pain, and no ST segment changes
    were noted in EKG.

    Cardiac CT:
    In addition, contiguous axial images of the heart were obtained on
    a multidetector CT with suspended respiration. Images were
    transferred to a Vitrea workstation for display and quantification
    of coronary artery calcification.

    Nuclear Scan:
    No fixed or reversible defects are apparent.
    Gated tomographic images show no left ventricular wall motion
    abnormalities with a left ventricular ejection fraction of 53%.

    Calcium scoring:

    LM: 0
    LAD: 0
    CFX: 0
    RCA: 0
    Total calcium score = 0

    1. Normal resting and exercise SPECT sestamibi myocardial
    perfusion examination.

    2. Coronary calcium score of 0 is consistent with no identifiable
    plaque with a very low risk of coronary artery disease.

    3. The combined nuclear and CT findings are consistent with very
    low risk of coronary artery disease and no hemodynamically
    significant coronary stenosis.

  2. Default

    My suggestion the following codes can be coded - 0144T for CT heart coronary calcium score, 78465 spect multiple studies , 78478 for wall motion, 78480 for ejection fraction.

    Joseph Amalraj Antonisamy CPC-H

  3. Default
    Code also for the cardiovascular stress test for the treadmill exercise portion with a code from 93015-95018 as appropriate, in addition to the TC-99 m Sestamibi A9500 if appropriate for your setting.

    Hope this helps,
    Anthony McCallum, CPC, CIRCC, CPC-I, CCS

  4. Unhappy Agree
    I agree with the coding scenario offered by the previous replies. Good luck getting paid for 0144T, however.

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