ICD Diagnostic Code for Calcium Scoring
There is no specific ICD diagnostic code for calcium scoring itself, as calcium scoring is a diagnostic procedure (CPT code), not a diagnosis. However, the appropriate ICD-10 diagnosis codes used to justify ordering calcium scoring typically reflect the clinical indication for the test.
Understanding the Distinction
- Calcium scoring is ordered using CPT code 75571 (Computed tomography, heart, without contrast material, with quantitative evaluation of coronary calcium), not an ICD code 1
- ICD-10 codes represent the clinical reason or diagnosis that justifies performing the calcium scoring procedure 2
Common ICD-10 Codes Used to Justify Calcium Scoring
The following diagnosis codes are typically used when ordering calcium scoring for asymptomatic risk assessment:
- Z13.6 - Encounter for screening for cardiovascular disorders (most commonly used for asymptomatic screening) 2
- Z82.49 - Family history of ischemic heart disease and other diseases of the circulatory system (when family history is the primary indication) 2
- E78.5 - Hyperlipidemia, unspecified (when elevated cholesterol is present) 2
- I25.10 - Atherosclerotic heart disease of native coronary artery without angina pectoris (when atherosclerosis is suspected but not yet confirmed) 2
Clinical Context for Code Selection
- Calcium scoring is most appropriately ordered for asymptomatic adults aged 40-75 years with intermediate (7.5-20%) or borderline (5-7.5%) 10-year ASCVD risk when decisions about preventive interventions are uncertain 2, 1
- The ICD-10 code should reflect the patient's risk factors or screening indication, such as family history of premature CAD, metabolic syndrome, or elevated lipids 2
Important Coding Pitfall
- Do not use chest pain codes (R07.x) or angina codes (I20.x) to justify calcium scoring, as symptomatic patients should not undergo calcium scoring—they require functional testing or CT angiography instead 1, 3
- In symptomatic patients with CAC=0, studies show 3.5% still had ≥50% stenosis and 1.4% had ≥70% stenosis, demonstrating that calcium scoring is inappropriate for symptomatic evaluation 1
Practical Approach
When ordering calcium scoring:
- Use CPT 75571 as the procedure code 1
- Select the ICD-10 diagnosis code that best reflects why you are ordering the test (typically Z13.6 for screening in intermediate-risk asymptomatic patients) 2
- Ensure the patient meets appropriate use criteria: asymptomatic, age 40-75, intermediate or borderline risk 2, 1