CT Coronary Angiogram

Just a reminder regarding Coronary Angiogram referred from Specialists - these studies can be bulk billed.  

When entering into Comrad – IT IS ONLY ONE VISIT and the CT Chest must NOT be included as an exam in the patient’s record. If the CT Chest is included, Medicare will reject the claim and only pay for the CT chest, not the CT coronary angiogram; we end up losing more than $400 for each test!

This process has been around for many, many years and unfortunately somehow in the past few weeks the incorrect billing and recording of exams is taking place.

Please do not add two visits – one for CT Chest and one for CT Coronary for Specialist referrals. 

(Separate visits only apply to patients who have been referred by GPs, as a GP is only able to refer for a CT Chest not the Coronary, and we therefore would bill for the CT Chest and not the Coronary in this instance).

In summary:

Specialist referral for Coronary

Coronary Angiogram Item 57360 (This item only to be billed – DO NOT ADD CT CHEST OR CALCIUM SCORE ETC) – 1 Visit only

GP referral for Coronary

Two referrals required = 1 for CT chest, 1 for CT coronary angiogram
2 separate visits = CT chest Bulk Billed, CT Coronary (code CTCA and must be put as no charge).

GP referral for Coronary (where Dr won’t provide 2 referrals)

Private Patient = Charge of $500.