About this policy
The information in this article contains billing, coding or other guidelines that complement the Local Coverage Determination (LCD) for Cardiac Computed Tomography & Angiography (CCTA) L33423. Refer to the Non-Invasive Fractional Flow Reserve (FFR) for Stable Ischemic Heart Disease L38278 LCD and related billing and coding article A58406 for more information regarding the use of add-on analysis of CCTA.
Codes in this policy
Code numbers and each code’s status as the policy records it. CPT code descriptions are left out of this page, as are the passages that cite CPT codes; the official document has them.
| Code | Code system | Status in this policy |
|---|---|---|
| 75571 | HCPCS | Covered |
| 75572 | HCPCS | Covered |
| 75573 | HCPCS | Covered |
| 75574 | HCPCS | Covered |
| A18.84 | ICD10CM | Covered |
| I11.0 | ICD10CM | Covered |
| I11.9 | ICD10CM | Covered |
| I20.0 | ICD10CM | Covered |
| I20.1 | ICD10CM | Covered |
| I20.89 | ICD10CM | Covered |
| I20.9 | ICD10CM | Covered |
| I24.0 | ICD10CM | Covered |
| I25.10 | ICD10CM | Covered |
| I25.110 | ICD10CM | Covered |
| I25.111 | ICD10CM | Covered |