For the CPT 2024 code set, Category I code 75580 and two parenthetical notes were established to report a noninvasive estimate of coronary fractional flow reserve (FFR) derived from augmentative software analysis of the data set from a coronary computed tomography angiography (CCTA). Category III codes 0501T-0504T and three associated parenthetical notes were deleted to accommodate the new code. This article provides an overview of these changes and additions.

Description of Procedure code 75574, 75580

 75574          Computed tomographic angiography, heart, coronary arteries and bypass grafts (when present), with contrast material, including 3D image postprocessing (including evaluation of cardiac structure and morphology, assessment of cardiac function, and evaluation of venous structures, if performed)

(For noninvasive estimate of coronary fractional flow reserve [FFR] derived from augmentative software analysis of the data set from a coronary computed tomography angiography with interpretation and report by a physician or other qualified health care professional, use 75580)

 75580         Noninvasive estimate of coronary fractional flow reserve (FFR) derived from augmentative software analysis of the data set from a coronary computed tomography angiography, with interpretation and report by a physician or other qualified health care professional

(Use 75580 only once per coronary computed tomography angiogram)

(When noninvasive estimate of coronary FFR derived from augmentative software analysis of the data set from a coronary computed tomography angiography with interpretation and report by a physician or other qualified health care professional is performed on the same day as the coronary computed tomography angiography, use 75580 in conjunction with 75574)

Before 2024, codes 0501T-0504T were used to report noninvasive estimated coronary FFR derived from CCTA data using computational fluid dynamics physiologic simulation–software analysis of functional data to assess the severity of coronary artery disease.

The augmentative software analysis represented by new code 75580 provides input that augments but does not replace the physician’s or other qualified health care professional’s (QHP’s) interpretation of the data set. Code 75580 includes the interpretation and report by a physician or other QHP.

An instructional parenthetical note indicates that code 75580 may be reported once per CCTA. An inclusionary parenthetical note indicates that when the noninvasive estimate of coronary FFR derived from augmentative software analysis of the data set from a CCTA is performed on the same day as the CCTA, code 75580 may be reported with code 75574. The cross-reference parenthetical note following code 75574 was revised to reflect the deletion of codes 0501T-0504T and the addition of code 75580.

The following clinical example and procedural description reflect a typical clinical scenario for which this new code would be appropriately reported.

Clinical Example (CPT code 75580)

A 60-year-old female, complaining of chest pains after exercising, previously underwent coronary computed tomographic angiography (CCTA) that showed coronary artery plaque and lumen narrowing of moderate severity (eg, 60% of the diameter narrowed) in the left anterior descending and right coronary arteries.

Description of Procedure (CPT code 75580)

Supervise the computed tomography (CT) technologist to ensure extraction of the appropriate CCTA data and images from the picture archiving and communication system (PACS) and ensure that the appropriate conforming image subsets are identified and collected. Review the computer platform–delivered CT-derived fractional flow reserve computed tomography (FFRCT) preliminary report, which involves the transformation of the static CT images into quantitative and qualitative diagnostic information about the function of the coronary arteries, distinct from the diagnostic output of the underlying CCTA. Once the data are processed and returned to the physician, the physician accesses the web-based interactive viewer. This allows the physician to examine and query the entire model and capture noninvasive estimated coronary FFR values anywhere within the coronary tree.

The physician reviews the anatomy and compares it with the estimated FFR model to reconcile discordant data, evaluate multiple and sequential lesions, and determine possible false-positive and false-negative results. This approach allows the imager and the interventional cardiologist to determine the location of the disease burden and the lesion with the most hemodynamic significance, allowing for a targeted interventional approach that yields the most benefit to patient. Prepare and notate a final report and document in patient’s record. Communicate study results to patient and referring physician to facilitate appropriate patient management. Dictate the final report in PACS for patient’s medical record. Enter a note into patient’s chart.