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CPT 75573: Cardiac CT for Congenital Heart Evaluation

CPT code 75573 denotes a contrast-enhanced cardiac computed tomography (CT) examination targeted at evaluating congenital cardiac anomalies, including three-dimensional post-processing and assessment of left and right ventricular structure and function. This procedure is clinically significant for noninvasive anatomic and functional characterization of congenital heart disease, aiding surgical planning, longitudinal surveillance, and multidisciplinary care coordination. Nationally, cardiac CT for congenital conditions has grown as imaging technology and post-processing capabilities improve, increasing its role alongside echocardiography and cardiac MRI.

Key payers referenced in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find an overview of coverage considerations and billing context across major payers, common modifier usage, and clinical indications tied to the code. The publication summarizes typical service settings and operational implications for radiology and cardiology practices, and highlights benchmarks and policy updates relevant to use of contrast-enhanced cardiac CT in congenital heart disease. Where specific payer policy text or utilization data are not present in the input, the publication notes that such detailed data are not available in the input.

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Billing Code Overview

CPT code 75573 describes a cardiac computed tomography (CT) study specifically performed to evaluate congenital cardiac anomalies. The procedure involves administration of intravenous contrast to delineate cardiac and vascular anatomy, permits assessment of left ventricular function, evaluation of right ventricular structure and function, and may include three-dimensional post-processing to better visualize complex congenital defects.

Service Type: Diagnostic cardiac CT with contrast for congenital heart disease evaluation

Typical Site of Service: Hospital outpatient radiology/imaging departments, outpatient imaging centers, and specialized cardiac CT labs

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CPT 75573: Cardiac CT for Congenital Heart Evaluation

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Billing Code Overview

Service Type: Diagnostic cardiac CT with contrast for congenital heart disease evaluation

Typical Site of Service: Hospital outpatient radiology/imaging departments, outpatient imaging centers, and specialized cardiac CT labs

Clinical & Coding Specifications

Clinical Context

A 28-year-old patient with a known congenital heart defect (such as tetralogy of Fallot repair in childhood) presents for noninvasive anatomic and functional assessment due to progressive exertional dyspnea and a new right-sided murmur. The cardiology team orders a contrast-enhanced cardiac CT for congenital heart disease evaluation to define intracardiac and extracardiac anatomy, evaluate right and left ventricular size and function, and assess vascular structures and surgical conduits.

The clinical workflow begins with scheduling in an outpatient or ambulatory imaging center with advanced cardiac CT capability. Pre-procedure screening checks renal function, allergy history, and prior imaging. On the day of service the patient is registered, IV access is obtained, and contrast consent is confirmed. The CT technologist performs ECG-gated CT acquisition with contrast under a supervising radiologist or cardiothoracic imaging cardiologist. The interpreting physician performs three-dimensional post-processing and formal measurement of ventricular function, vascular anatomy, and any residual or recurrent congenital lesions. The final report includes multiplanar and 3D reconstructions and quantitative left ventricular function assessment when performed.

Coding Specifications

Modifier	Description	When to Use
`26`	Professional component	When reporting only the physician interpretation separate from technical imaging performed by the facility.
`TC`	Technical component	When reporting only the facility/technical component (scanner, technologist, contrast) without physician interpretation.
`59`	Distinct procedural service	When another separate imaging procedure or intervention is performed in a distinct session or anatomical site and needs separation from the cardiac CT.
`52`	Reduced services	When the CT is partially reduced in scope (for example, non-diagnostic segments or abbreviated acquisition) and full service is not provided.
`53`	Discontinued procedure	When the CT study is started but discontinued due to patient instability or severe contrast reaction.
`62`	Two surgeons	When two physicians of the same specialty share responsibility for a complex imaging-guided procedure interpretation (rare for CT interpretation but applicable if policy requires).
`78`	Unplanned return to operating/procedure room by the same physician following initial procedure	If an immediate repeat imaging-guided intervention occurs under the same operative episode (limited applicability).
`80`	Assistant surgeon	Rarely used for imaging; included when an assisting physician provides a portion of the professional service as allowed by payer rules.
`22`	Increased procedural services	When the interpreting physician documents and justifies significantly greater complexity, time, or effort than typical for this CT.
`26`	(duplicate entry removed in table)	Data integrity note: only list once per payer submission.

Taxonomy Code	Specialty	Notes
2084P0800X	Diagnostic Radiology	Radiologists commonly perform and interpret cardiac CT studies.
207RC0000X	Cardiovascular Disease	Cardiologists, particularly advanced imaging cardiologists, interpret and request congenital cardiac CTs.
2084N0402X	Thoracic Radiology	Subspecialty radiologists who focus on chest and cardiac imaging perform detailed cardiac CT interpretations.
208Z00000X	Emergency Medicine	Emergency physicians may order or interpret emergent cardiac CTs in acute presentations.
207L00000X	Pediatric Cardiology	Pediatric cardiologists manage congenital heart disease patients and often coordinate cardiac CT imaging.

Related Diagnoses

ICD-10 Code	Description	Clinical Relevance
Data not available in the input.	Data not available in the input.	Data not available in the input.

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`71250`	CT chest without contrast material, followed by contrast material(s) and further sections	May be used when additional noncardiac chest contrast-enhanced CT imaging is performed in conjunction with cardiac CT to evaluate thoracic vasculature.
`75571`	CT angiography, chest, with contrast, including non-contrast images if performed; image post-processing when performed	May be used for dedicated CT angiography of thoracic vasculature when broader vascular assessment is required alongside congenital heart CT.
`93750`	Ambulatory blood pressure monitoring, wearing device, recording and interpretation	Often ordered in the overall cardiac assessment workflow but not part of imaging billing; included when concurrent hemodynamic evaluation is documented.
`93306`	Echocardiography, transthoracic, real-time with image documentation, complete	Commonly performed before or after CT to evaluate valvular function and provide complementary functional data.
`76376`	3D rendering with interpretation and reporting of CT/angiography studies	Used when advanced three-dimensional post-processing and rendering are performed as part of the cardiac CT study.

CPT 75557: Cardiac MRI for Structure and Function, No Contrast

CPT-75559-CARDIAC-MRI-STRESS-NON-CONTRAST

CPT 75559: Cardiac MRI with Stress, Non-Contrast

CPT-75561-CARDIAC-MRI-WITH-AND-WITHOUT-CONTRAST

CPT 75561: Cardiac MRI Without and With Contrast

CPT-75563-CARDIAC-MRI-STRESS-REST-WITH-AND-WITHOUT-CONTRAST

CPT 75563: Cardiac MRI Stress and Rest with and without Contrast

CPT-75565-CARDIAC-MRI-VELOCITY-FLOW-MAPPING

CPT 75565: Cardiac MRI with Velocity Flow Mapping

CPT-75571-CORONARY-CALCIUM-SCORING-CT-NON-CONTRAST

CPT 75571: Non-Contrast CT Coronary Calcium Scoring

CPT-75572-CARDIAC-CT-3D-POST-PROCESSING-FUNCTIONAL-ASSESSMENT

CPT 75572: Cardiac CT with 3D Post-Processing and Functional Assessment

CPT-75574-CARDIAC-CT-WITH-CONTRAST-CORONARY-EVALUATION

CPT 75574: Cardiac CT With Contrast for Coronary Evaluation

CPT-75577-CORONARY-CTA-PLAQUE-QUANTIFICATION-POST-PROCESSING

CPT 75577: Coronary CTA Plaque Quantification and Post-Processing

CPT-75580-FFR-CT-FROM-CCTA-AUGMENTATION-SOFTWARE-REPORT

CPT 75580: FFR-CT from Coronary CT Angiography via Augmentative Software

References

1.CPT® Codes and Descriptions. AAPC. Retrieved Jul 29, 2026.
2.HCPCS Quarterly Update. Centers for Medicare & Medicaid Services (CMS). Retrieved Jul 29, 2026.
3.ICD-10-CM Full Code List. Centers for Medicare & Medicaid Services (CMS). Retrieved Jul 29, 2026.

Published by

Trek Health powers OpenPayer with a leading commercial payer intelligence platform, seamlessly converting fragmented payer data into actionable insights for provider organizations.

Trek Health ingests and normalizes Transparency in Coverage data and payer policy updates to give provider organizations a clear view of how commercial reimbursement behaves across markets, payers, and services. Our platform transforms raw payer disclosures into structured intelligence that supports contract evaluation, payer negotiations, and service line strategy. By combining market benchmarks with ongoing policy visibility, Trek helps teams identify variability, risk, and opportunity in commercial reimbursement. The result is faster insight, stronger negotiating positions, and more informed financial decisions.

Clinical & Coding Specifications

Clinical Context

Coding Specifications

Modifier	Description	When to Use
`26`	Professional component	When reporting only the physician interpretation separate from technical imaging performed by the facility.
`TC`	Technical component	When reporting only the facility/technical component (scanner, technologist, contrast) without physician interpretation.
`59`	Distinct procedural service	When another separate imaging procedure or intervention is performed in a distinct session or anatomical site and needs separation from the cardiac CT.
`52`	Reduced services	When the CT is partially reduced in scope (for example, non-diagnostic segments or abbreviated acquisition) and full service is not provided.
`53`	Discontinued procedure	When the CT study is started but discontinued due to patient instability or severe contrast reaction.
`62`	Two surgeons	When two physicians of the same specialty share responsibility for a complex imaging-guided procedure interpretation (rare for CT interpretation but applicable if policy requires).
`78`	Unplanned return to operating/procedure room by the same physician following initial procedure	If an immediate repeat imaging-guided intervention occurs under the same operative episode (limited applicability).
`80`	Assistant surgeon	Rarely used for imaging; included when an assisting physician provides a portion of the professional service as allowed by payer rules.
`22`	Increased procedural services	When the interpreting physician documents and justifies significantly greater complexity, time, or effort than typical for this CT.
`26`	(duplicate entry removed in table)	Data integrity note: only list once per payer submission.

Taxonomy Code	Specialty	Notes
2084P0800X	Diagnostic Radiology	Radiologists commonly perform and interpret cardiac CT studies.
207RC0000X	Cardiovascular Disease	Cardiologists, particularly advanced imaging cardiologists, interpret and request congenital cardiac CTs.
2084N0402X	Thoracic Radiology	Subspecialty radiologists who focus on chest and cardiac imaging perform detailed cardiac CT interpretations.
208Z00000X	Emergency Medicine	Emergency physicians may order or interpret emergent cardiac CTs in acute presentations.
207L00000X	Pediatric Cardiology	Pediatric cardiologists manage congenital heart disease patients and often coordinate cardiac CT imaging.

Related Diagnoses

ICD-10 Code	Description	Clinical Relevance
Data not available in the input.	Data not available in the input.	Data not available in the input.

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`71250`	CT chest without contrast material, followed by contrast material(s) and further sections	May be used when additional noncardiac chest contrast-enhanced CT imaging is performed in conjunction with cardiac CT to evaluate thoracic vasculature.
`75571`	CT angiography, chest, with contrast, including non-contrast images if performed; image post-processing when performed	May be used for dedicated CT angiography of thoracic vasculature when broader vascular assessment is required alongside congenital heart CT.
`93750`	Ambulatory blood pressure monitoring, wearing device, recording and interpretation	Often ordered in the overall cardiac assessment workflow but not part of imaging billing; included when concurrent hemodynamic evaluation is documented.
`93306`	Echocardiography, transthoracic, real-time with image documentation, complete	Commonly performed before or after CT to evaluate valvular function and provide complementary functional data.
`76376`	3D rendering with interpretation and reporting of CT/angiography studies	Used when advanced three-dimensional post-processing and rendering are performed as part of the cardiac CT study.

CPT 75557: Cardiac MRI for Structure and Function, No Contrast

CPT-75559-CARDIAC-MRI-STRESS-NON-CONTRAST

CPT 75559: Cardiac MRI with Stress, Non-Contrast

CPT-75561-CARDIAC-MRI-WITH-AND-WITHOUT-CONTRAST

CPT 75561: Cardiac MRI Without and With Contrast

CPT-75563-CARDIAC-MRI-STRESS-REST-WITH-AND-WITHOUT-CONTRAST

CPT 75563: Cardiac MRI Stress and Rest with and without Contrast

CPT-75565-CARDIAC-MRI-VELOCITY-FLOW-MAPPING

CPT 75565: Cardiac MRI with Velocity Flow Mapping

CPT-75571-CORONARY-CALCIUM-SCORING-CT-NON-CONTRAST

CPT 75571: Non-Contrast CT Coronary Calcium Scoring

CPT-75572-CARDIAC-CT-3D-POST-PROCESSING-FUNCTIONAL-ASSESSMENT

CPT 75572: Cardiac CT with 3D Post-Processing and Functional Assessment

CPT-75574-CARDIAC-CT-WITH-CONTRAST-CORONARY-EVALUATION

CPT 75574: Cardiac CT With Contrast for Coronary Evaluation

CPT-75577-CORONARY-CTA-PLAQUE-QUANTIFICATION-POST-PROCESSING

CPT 75577: Coronary CTA Plaque Quantification and Post-Processing

CPT-75580-FFR-CT-FROM-CCTA-AUGMENTATION-SOFTWARE-REPORT

CPT 75580: FFR-CT from Coronary CT Angiography via Augmentative Software

References

1.CPT® Codes and Descriptions. AAPC. Retrieved Jul 29, 2026.
2.HCPCS Quarterly Update. Centers for Medicare & Medicaid Services (CMS). Retrieved Jul 29, 2026.
3.ICD-10-CM Full Code List. Centers for Medicare & Medicaid Services (CMS). Retrieved Jul 29, 2026.

Published by

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CPT 75573: Cardiac CT for Congenital Heart Evaluation

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Billing Code Overview

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CPT 75573: Cardiac CT for Congenital Heart Evaluation

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Billing Code Overview

Clinical & Coding Specifications

Clinical Context

Coding Specifications

Related Diagnoses

Related CPT Codes

Related Codes

References

Clinical & Coding Specifications

Clinical Context

Coding Specifications

Related Diagnoses

Related CPT Codes

Related Codes

References