Cardiac CT billing has 3 parts that get mixed up: the calcium score, the angiogram and the read. The score and angiogram never share a claim, and your scan site decides the read's modifier. We sort that out before the claim leaves.
3% of collectionsNo setup feeNo contract
Coronary CTA with contrast is 75574. In your office, contrast goes on its own line, per mL, with the volume in the note.
75571 is the standalone calcium score. NCCI bundles it into 75574 when both run in 1 session, so it stays off that claim. Sent together, 75571 denies on an NCCI edit.
Medicare and many commercial plans treat a calcium score alone as screening, and don't pay it. We tell you before the scan, so the patient pays a known price. Most commercial and Medicare Advantage plans need prior authorization for 75574, and we get it first.
In your office, 75574 global covers your scan and your read. You bill it under your group's enrollment once the scanner is accredited and its location is added.
In a hospital, you bill 75574-26 for your read only. The hospital bills the facility claim, contrast included. A missing 26 gets the claim rejected, or paid as global and taken back in an audit.
FFR-CT is 75580, a Category I code since 2024. Coverage is plan by plan and usually needs its own authorization. We check yours before the study.
Coding and claims75574
Your scan and your read
75574-26
Your read only
Cardiac MRI codes 75557 to 75563 split on 2 questions: contrast or not, stress or not. 75557 is without contrast, and 75559 adds stress. 75561 adds contrast, for scar and viability, and 75563 adds both.
A report that doesn't describe the post-contrast sequences doesn't support 75561, and a strict reviewer pays 75557. We read the report before we pick the code.
When your MRI read is denied for diagnosis, we appeal with your order and signed read.
Denials and appealsEach code pays only when your signed report supports it. Gadolinium is its own supply line, billed by whoever owns the scanner.
| Code | Study |
|---|---|
| 75574 | Coronary CTA with contrast, 75571 bundled into it |
| 75571 | Calcium score, standalone (screening for many payers) |
| 75572, 75573 | Cardiac CT with contrast: structure, congenital |
| 75557, 75559, 75561, 75563 | Cardiac MRI, by contrast and stress |
| 75565 | Velocity flow mapping add-on |
| 75580 | FFR-CT from the CTA data |
We show you which reads went out without 26 and which calcium scores were denied. Free, no strings.
3% of collectionsNo setup feeNo contract