CPT Codes 75572, 75573, 75574
Cardiac CT angiography is now a core diagnostic tool in cardiology for assessing coronary artery disease, structural heart conditions, congenital abnormalities, and pre-procedural planning. Because cardiac CTA involves imaging, 3D reconstruction, contrast use, ECG-gating, and interpretation components, coding and documentation must be extremely precise.
This guide provides a fully factual, practical billing framework with no sales language—only actionable information for compliant, accurate cardiovascular billing.
Understanding Cardiac CTA CPT Codes (75572–75574)
Cardiac CTA is billed using three main CPT codes, differentiated by the level of anatomical coverage and inclusion of 3D postprocessing.
75572 – Cardiac CTA without coronary artery evaluation
Includes:
- Cardiac structure imaging
- Functional morphology assessment
- 3D reconstruction
Used for:
- Structural heart disease
- Congenital anomalies (non-coronary)
- Cardiac masses
- Pericardial disease
- Pulmonary vein anatomy (e.g., AF ablation planning)
Does NOT include coronary artery assessment.
75573 – Cardiac CTA for congenital anomalies (full anatomic evaluation)
Includes:
- Congenital heart disease
- Detailed structural mapping
- 3D postprocessing
Used for:
- TOF, TGA, TAPVR, truncus, complex congenital defects
- Pre-surgical or pre-interventional evaluation
This code applies when there is complex congenital anatomy requiring additional imaging and interpretation.
75574 – Cardiac CTA including coronary artery evaluation (coronary CTA)
Includes:
- Coronary artery imaging
- Calcium scoring, if performed as part of CTA
- ECG-gated imaging
- 3D renderings
- Functional cardiac structure evaluation
Used for:
- Chest pain evaluation
- Coronary artery disease assessment
- Rule out ACS in low-to-intermediate risk patients
- Coronary anomalies
- Stent or graft evaluation (depending on size, motion, image quality)
75574 is the most commonly used code in outpatient cardiology.
What’s Included in CPT 75572–75574
All three cardiac CTA codes include:
- CT data acquisition
- Post-processing
- 3D rendered images
- Interpretation and report
- ECG gating (prospective or retrospective)
- IV contrast administration supervision
- Image reconstruction and workstation manipulation
Do NOT bill 3D postprocessing (76376/76377) with 75572–75574; it is already included.
What’s NOT Included (Separately Billable When Applicable)
The following services are separately billable when medically necessary:
1. Calcium Scoring (75571)
Only billable when performed independently, not bundled into diagnostic CTA unless documented as a standalone test.
2. CT for Pulmonary Veins (non-cardiac)
If performed as a separate non-cardiac CT, bill under chest CT codes (71260) when properly supported.
3. Stress Testing
If stress imaging is performed separately before/after CTA.
4. Contrast Material (HCPCS)
E.g., J7050, J7030, specific contrast agent HCPCS codes—varies by payer.
5. Beta-blocker or nitroglycerin administration
Injection codes are billable when administered and documented.
Diagnostic Criteria for Billing Cardiac CTA Correctly
Payers require strict medical necessity. Documentation should clearly support:
- Chest pain characteristics (stable, unstable, atypical)
- CAD risk factors (HTN, diabetes, smoking, family history)
- Abnormal ECG findings
- Equivocal stress test
- Prior indeterminate imaging
- Pre-procedural assessment (TAVR, CABG planning, ablation planning)
- Known congenital heart disease
Avoid vague indications like:
- “Chest pain” (without description)
- “CAD screening”
- “Follow-up”
Clear clinical detail is essential for coverage.
Documentation Requirements (Essential Elements)
Every CTA report must clearly include:
1. Indication
Specific symptoms or disease states.
Example: “Evaluation of atypical chest pain in a 54-year-old male with intermediate CAD risk.”
2. Technique
- Scanner type
- Detector rows
- Prospective vs retrospective ECG gating
- Contrast type and volume
- Heart rate control methods
- Imaging phases obtained
3. Coronary Artery Evaluation (for 75574)
- LM, LAD, LCx, RCA
- Stenosis severity (%)
- Plaque characteristics (calcified, non-calcified, mixed)
- Vessel dominance
- Stent/graft visualization details
4. Structural Findings (all codes)
- Chamber size
- Pericardium
- Aorta
- Pulmonary veins
- Valvular morphology
- Right ventricular outflow tract
- Congenital abnormalities
5. 3D Post-processing Workstation Work
Already included, but must be described (e.g., multiplanar reformats, curved planar reformats).
6. Final Impression
Must summarize:
- Coronary findings
- Noncardiac incidental findings
- Recommendations
Billing Scenarios (Practical Examples)
Scenario A: Coronary CTA (most common)
Chest pain + intermediate risk → 75574
Scenario B: CTA for pulmonary vein isolation planning
AF ablation planning → 75572
(Non-coronary cardiac anatomy)
Scenario C: Congenital Heart Disease
Repair planning for TGA → 75573
Scenario D: Coronary CTA + Calcium Score
Billing rules:
- If a calcium score is done as part of CTA, do not bill 75571
- If done independently before CTA, bill 75571 separately (with clear documentation)
Scenario E: Emergency Department Coronary CTA
Rule-out ACS
→ 75574 if medically necessary and performed with ECG gating.
Facility vs Professional Component (26/TC Modifiers)
When the same entity provides BOTH technical + professional:
- Bill globally (no modifiers)
When the hospital provides technical & the physician provides interpretation:
- Hospital: 75572–75574 -TC
- Physician: 75572–75574 -26
Hospitals frequently bill technical, cardiologists bill professional.
Modifiers & Special Billing Notes
Modifier 26
Use when billing interpretation only.
Modifier TC
Use when only billing the technical component.
Modifier 59 / XU
Rarely used with CTA, but may apply when other CT imaging is performed the same day for unrelated reasons.
Modifier 76 / 77
Repeat CTA on the same day—only allowed with:
- Clinical deterioration
- Inadequate first study requiring a complete re-scan
- Documentation must be strong.
Payer-Specific Challenges & Prior Authorization
Cardiac CTA is heavily controlled by prior authorization, especially:
- Medicare Advantage
- Commercial payers (Aetna, BCBS, United, Cigna, Humana)
Common reasons for denial:
- Lack of symptoms
- Stress test not done when required by policy
- CTA used as a first-line test without justification
- Calcium scoring was billed incorrectly
- Incomplete report elements
To avoid denial:
- Include all symptoms
- Explain equivocal stress or echo tests
- Provide detailed medical necessity links
- Use structured CTA templates
- Follow AUC (Appropriate Use Criteria)
Coronary CTA vs Calcium Score Billing Clarification
Calcium Scoring Alone = 75571
Used for:
- Screening
- Risk stratification
Coronary CTA (75574) includes:
- Anatomy
- Stenosis evaluation
- Morphology
- Coronary mapping
Do not bill both 75574 + 75571 for the same encounter unless they were performed as two separate clinical tests with distinct indications.
Documentation must clearly show:
- Separate orders
- Independent interpretation
- Separate clinical need
Medical Necessity Requirements (High-Value Summary)
To be considered medically necessary, CTA must meet one of the following:
Symptomatic patients
- Chest pain
- Dyspnea
- Palpitations
- Low-to-intermediate CAD risk
Abnormal tests needing clarification
- Indeterminate stress test
- Non-diagnostic echo
- Abnormal but unclear ECG
Planning imaging
- TAVR
- CABG
- Pulmonary vein isolation
- Congenital repair
Coronary anomalies
Congenital or acquired.
Billing Pitfalls (Common Mistakes Leading to Denials)
Mistake 1: Missing ECG gating documentation
Payers require proof of appropriate gating for 75574.
Mistake 2: Use of 3D reconstruction codes
76376 and 76377 are NOT separately billable with CTA.
Mistake 3: Billing 75574 for non-coronary indications
Check whether the indication involves coronary evaluation.
Mistake 4: Incorrect use of calcium scoring add-ons
Avoid billing 75571 unless performed independently.
Mistake 5: Lack of medical necessity description
“Rule-out CAD” without context → denial.
Checklist for a Complete CTA Report (Meets CPT & Payer Standards)
✓ Indication with symptoms
✓ Risk factors
✓ Heart rate control description
✓ Contrast type, route, and dose
✓ Prospective vs retrospective gating
✓ Technical details (slice thickness, scanner type)
✓ Coronary anatomy & stenosis % (75574 only)
✓ Chamber structure and function
✓ Aorta and pulmonary artery evaluation
✓ RV/LV inflow and outflow tracts
✓ Pulmonary veins
✓ Incidental findings
✓ 3D postprocessing description
✓ Signed interpretation
A complete report strengthens medical necessity and coding defensibility.
Conclusion
Cardiac CTA billing requires strict attention to CPT code definitions, anatomical intent, medical necessity, gating technique, and structured reporting. Accurate use of 75572, 75573, and 75574 depends on whether the study evaluates coronary arteries, congenital structural anatomy, or non-coronary cardiac structures. Consistent, clear documentation is essential for compliance and reducing audit risk. Many cardiology practices standardize CTA protocols and billing workflows with support from experienced partners like Global Tech Billing LLC to maintain accuracy and payer alignment.
FAQs
1. What is the main difference between 75572, 75573, and 75574?
75572 is non-coronary cardiac CTA, 75573 is congenital CTA, and 75574 includes coronary artery evaluation.
2. Can calcium scoring be billed with cardiac CTA?
Only if performed independently; otherwise it is included in coronary CTA.
3. What documentation is required for 75574?
ECG gating, coronary artery findings, stenosis %, contrast details, and full structural evaluation.
4. Is 3D postprocessing separately billable?
No. It is included in all cardiac CTA CPT codes.
5. Are contrast agents separately billable?
Yes, when documented with units and HCPCS codes.
6. When is prior auth required?
Almost always for commercial and Medicare Advantage plans.
7. Can CTA replace stress testing?
Yes, in certain intermediate-risk cases, but documentation must support appropriateness.
8. Who bills 26 vs TC?
Physicians bill -26 (interpretation), facilities bill -TC (technical component).
