A: When a study of the coronary arteries and imaging of the heart for wall thickness, including ejection fractions and stroke volumes, is performed, it would be appropriate to code for a CTA of the chest (71275) with the addition of a –22 modifier to indicate unusual procedural services above and beyond that which is ordinarily performed. A CT of the thorax should not be coded. Just as a dedicated splenic CTA would be a CTA of the abdomen, a targeted CTA of the coronaries would be CTA of the chest. Likewise, interpretation of a CTA of the abdomen includes interpretation of the axial data set, and the same is true for CTA of the thorax. It is not appropriate to code for a 76375 for reconstruction, because the 3-D work is included in the CTA code. Currently a code does not exist for the ejection fraction work of this procedure; therefore, it is recommended that the –22 be used in addition to the CTA code, with an appropriate increase in charges to reflect the extra work.
Please reference the May/June ACR Radiology Coding Source™ for a discussion of CTA and when it is appropriate to code for both CT and CTA.