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Thread: Query on 78452

  1. #1

    Default Query on 78452

    AAPC: Back to School
    Please review the below report and confirm me whether we can code CPT 78452 & 75771 together?CPT 75571 is getting denied by Medicare stating “Routine and Screening services not covered”.Please provide me any guidlines for using this CPT.

    TECHNIQUE: Following the intravenous administration of 3.3 mCi of
    Technetium-99m sestamibi with the patient at rest, tomographic
    images of the heart were performed. Subsequently during peak
    treadmill exercise, the patient received a additional intravenous
    dose of 26.1 mCi of Technetium-99m sestamibi, and additional
    tomographic images were performed. The patient achieved a peak
    heart rate of 146 beats per minute (87% of maximal predicted heart
    rate) and a maximal blood pressure of 140/80 mm Hg. The patient
    experienced no chest pain, and there were no ST segment changes
    during exercise.

    In both the stress and rest tomographic images tracer distribution
    is homogeneous and physiologic throughout the entire left
    ventricular myocardium.

    Gated tomographic images with the patient at rest demonstrate
    normal left ventricular wall motion and wall thickening. Left
    ventricular ejection fraction is 53 %. End systolic and end
    diastolic volumes are normal.


    Calcium scoring:

    LM: 76
    LAD: 12
    CFX: 0
    RCA: 0
    Total calcium score = 88


    Normal study.

    1. There is no scan evidence of exercise induced myocardial

    2. Left ventricular systolic function at rest is normal with LVEF
    of 53%. End systolic and end diastolic volumes are normal.

    3. Coronary calcium score of 88 implies definite, at least mild
    atherosclerotic plaque formation with a likelihood of mild or
    minimal coronary artery narrowing.

    4. The combined myocardial perfusion scan and coronary calcium
    score findings are consistent with at least mild atherosclerotic
    plaque formation in the left main and left anterior descending
    arteries which is not hemodynamically significant.
    Prabha CPC

  2. #2


    Check with medicare for your state, it may be that these two exams can not be on the same date and for the same reason, such as MRI & MRA brain here in ND. Also check for any LCD's for your area for these procedures because the diagnosis may not be coverable

  3. #3

    Default 75771 not valid code

    75771 is not valid CPT code
    Ellen Cooper, CPC

  4. #4


    it's 75571.

  5. #5
    Join Date
    Apr 2007
    Dallas, GA


    Our hospital requires patients to prepay for CT cardiac scoring exams and does not take insurance for them. We actually bill the hospital to get paid because these exams are not typically covered by insurance.

    This is a draft article from 2009 but I think the rules still stand…..
    Medicare: http://www.cms.gov/medicare-coverage...RAD034_CBG.pdf
    Last edited by chembree; 12-16-2011 at 06:05 AM. Reason: typo

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