Compliance Question of the Week – Question of the Week

When is CPT® add-on code +0993T reported for augmentative software analysis performed with a CT scan of the heart? Case Example: A patient with multiple cardiovascular risk factors, including obesity, hypertension, a history of smoking, and elevated inflammatory markers, underwent coronary CT angiography (CCTA) for evaluation of coronary artery disease. The patient was placed supine in the CT scanner, and a gated coronary CT angiography study was performed using standard institutional protocol with intravenous contrast. Image quality was confirmed adequate for diagnostic review. Immediately following image acquisition, the CCTA dataset was transferred to an AI-powered perivascular fat analysis platform. The software automatically identified the coronary arteries, extracted perivascular fat regions, and calculated vessel-specific fat attenuation index (FAI) measurements associated with coronary vascular inflammation. Clinical risk factors, including body mass index (BMI), smoking history, high-sensitivity C-reactive protein (hs-CRP), and blood pressure, were incorporated into the software analysis to refine the inflammation-based risk assessment. The platform generated a comprehensive cardiac inflammation profile that integrated coronary plaque characteristics with biologic inflammatory markers. The interpreting cardiologist reviewed both the primary CCTA findings and the AI-generated FAI metrics. The combined report concluded: (1) no obstructive coronary artery disease, (2) mixed noncalcified plaque within the proximal left anterior descending (LAD) artery, and (3) elevated FAI values indicating increased vascular inflammatory activity. Based on these findings, therapy intensification was recommended.

Have HCPCS codes C9600–C9608 changed for 2026?

How could the proposed efficiency adjustment and facility PE reductions impact reimbursement for cardiology services, and what strategies can practices use to offset potential revenue declines?