Question:
A 63-year-old female with hyperlipidemia and a family history of premature coronary artery disease undergoes coronary risk stratification. The cardiologist retrieves a prior noncontrast thoracic CT scan that was originally performed for chronic cough and submits the existing images to an AI-enabled perivascular fat analysis platform. The software analyzes the coronary arteries, calculates perivascular fat attenuation indices (FAI), incorporates patient-specific clinical data, and generates an inflammation-based cardiac risk assessment. The physician reviews the AI-generated findings, correlates them with the patient’s cardiovascular history, and documents an interpretive report that includes treatment recommendations. No new CT scan is performed on the date of service. Is it appropriate to report CPT® code 0992T for this service?
Answer:
Yes. CPT® code 0992T may be reported when an augmentative cardiac risk assessment is performed using previously acquired CT data and no concurrent CT scan of the heart is performed on the same date of service.
In this scenario, the physician utilized existing thoracic CT images to perform AI-assisted perivascular fat analysis. The software calculated perivascular fat attenuation indices (FAI), a biomarker associated with coronary inflammation, and incorporated patient-specific clinical information to generate individualized risk stratification. The resulting analysis produced vessel-specific inflammation measurements and prognostic risk information that the physician reviewed and incorporated into the final report.
A key compliance consideration is that code 0992T is reported once per CT scan when the augmentative analysis is performed on previously acquired imaging rather than in conjunction with a new cardiac CT study on the same date of service. Physician or other qualified healthcare professional interpretation and reporting are inherent components of the code and must be documented in the medical record.
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