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    v1.0.30
    OpenPayerBilling CodesAutomated Analysis of Vertebral FractureCPT cpt-0691t-automated-ct-vertebral-fracture-analysis
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    CPT 0691T: Automated CT Analysis for Vertebral Fracture Detection and Bone Density

    CPT code 0691T describes an automated analysis of an existing computed tomography (CT) dataset that checks for vertebral fractures and may assess bone density, and includes data preparation, image processing, interpretation, and a clinician report; this service is an automated image analysis typically provided as a diagnostic radiology informatics service and is performed using previously acquired CT images in radiology departments, imaging centers, or integrated hospital outpatient settings where CT datasets are available for secondary analysis.

    For related coverage guidance, see recent payer policy updates: Diabetic Supplies, Radiofrequency Ablation for Thyroid Nodules, Continuous Glucose Monitoring and Insulin Delivery for Managing Diabetes (for Idaho Only).

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    Clinical & Coding Specifications

    Clinical Context

    A 72-year-old woman with a history of osteoporosis and recent minor height loss is seen by her primary care physician after she reports mid-thoracic back pain following a household fall. A prior chest and abdominal CT performed two weeks earlier for unrelated reasons is available in the radiology PACS. The clinician requests an automated vertebral fracture assessment using 0691T to screen the existing CT dataset for vertebral compression fractures and to assess opportunistic bone density.

    Workflow: The radiology practice locates the existing CT series and transmits the DICOM dataset to an FDA-cleared automated analysis software. The service includes data preparation (segmentation and quality checks), automated algorithmic detection of vertebral body deformities, optional quantitative bone density metrics, and radiologist review of the generated images and structured results. The radiologist documents interpretation and final report; when applicable, the professional component modifier 26 is appended. The technical component (software processing and image storage) may be billed with modifier TC when separated. Typical sites of service include outpatient imaging centers, hospital radiology departments, and teleradiology services supporting remote reads. Common clinical indications include suspected vertebral compression fracture, osteoporosis screening, trauma screening, or incidental evaluation during CT performed for other indications.

    Related CPT Codes

    CPT CodeDescriptionRelationship to This Procedure
    71250CT chest without contrast materialMay generate an existing thoracic CT dataset that is eligible for opportunistic automated vertebral fracture analysis with 0691T.
    74177CT abdomen and pelvis with contrast, including image post-processing when performedAbdominal/pelvic CTs that include portions of the thoracolumbar spine can be analyzed by 0691T for incidental vertebral fractures and bone density assessment.
    72157MR lumbosacral spine without contrastMR spine is an alternative modality for dedicated evaluation; MR may be performed after 0691T flags a suspected fracture requiring confirmatory imaging.
    77080Dual-energy X-ray absorptiometry (DXA) bone density study, axial (central)DXA is the standard quantitative bone density test often ordered after 0691T reports low bone density or suggests osteoporosis.
    76140

    Related Modifiers

    6 rows

    ModifierDescriptionWhen to Use
    26Modifier 26 (Professional Component) identifies and bills only the professional portion of a split service — the physician’s interpretation, report, and medical judgment — when the technical…- Use CPT Modifier -26 when you are billing only the professional component (PC) of a split‑bill eligible service—i.e., you performed the physician interpretation, medical judgment and prepared a…
    52Modifier ‑52 (Reduced Services) indicates that a service or procedure was partially reduced or omitted at the provider’s discretion, allowing reporting of the basic procedure number with a qualifier…- Use modifier -52 when a physician or qualified health professional electively reduces or omits part of a procedure or service (for example, performing fewer required views or omitting a portion of…
    53Modifier 53 (Discontinued Procedure) signals that a surgical or diagnostic service was begun by the physician but terminated because of extenuating circumstances that threatened the patient’s…- Use modifier -53 when a physician/qualified healthcare professional has started a surgical or diagnostic procedure (e.g., anesthesia administered, incision or scope insertion) and then discontinues…
    78CPT modifier -78 indicates an unplanned, related return to the operating or procedure room by the same provider during the global postoperative period. It is appended when treatment for a…- Use modifier -78 when an unplanned, related complication during the original procedure’s global postoperative period requires the patient to return to a formal operating or procedure room and the…
    22Modifier –22 (Increased Procedural Services) is used when a reported procedure is substantially more extensive than normally required. The CPT Manual and CMS state it may be appended only when the…- When to use: Append modifier -22 to a procedural CPT code when the service performed is substantially more extensive than the usual service described by that code — i.e., the procedure required…
    62Modifier 62 indicates that two surgeons function as co‑surgeons, each performing distinct parts of the same primary surgical procedure. It is appended to the primary procedure code (and any…- Use modifier -62 when two surgeons act as co‑surgeons (both primary surgeons) on a single definitive primary procedure, each performing distinct parts of the same surgical procedure (append -62 to…

    Related Provider Taxonomies

    8 rows

    Taxonomy Code
    207RC0000X
    2084P0800X
    207L00000X
    364S00000X
    163WX1100X
    207RA0002X
    207YX0602X
    207SG0205X

    Related Payer Policy Updates

    Specialty: Endocrinology1 / 3

    10 rows

    PolicyPayerEffective Date
    Diabetic SuppliesCigna2026-10-15
    Radiofrequency Ablation for Thyroid NodulesCigna2026-10-15
    Continuous Glucose Monitoring and Insulin Delivery for Managing Diabetes (for Idaho Only)UnitedHealthcare2026-10-01
    Tzield (teplizumab-mzwv) CoverageUnitedHealthcare2026-10-01
    Continuous Glucose Monitoring and Insulin Delivery for Managing Diabetes (for Indiana Only)UnitedHealthcare2026-10-01
    Medical Necessity Guidelines Insulin PumpsMass General Brigham Health Plan2026-10-01
    Medical Necessity Guidelines: Continuous Glucose MonitorsMass General Brigham Health Plan2026-10-01
    Continuous Glucose MonitoringAmbetter Nevada2026-10-01
    Salivary Hormone TestingOscar Health2026-10-01
    Bone Turnover Markers TestingOscar Health2026-10-01

    Frequently Asked Questions

    References

    1. 1.CPT® Codes and Descriptions. AAPC. Retrieved Aug 11, 2026.Maintains the CPT code set's official descriptions and guidelines, licensed from the American Medical Association, used as the definitional source for CPT codes on this page.
    2. 2.HCPCS Quarterly Update. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's quarterly release of HCPCS Level II codes and short/long descriptors, the source for HCPCS code definitions and update history.
    3. 3.ICD-10-CM Full Code List. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's complete ICD-10-CM diagnosis code list, used to cross-reference diagnosis codes associated with this procedure or service.
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    CT guidance for biopsy, percutaneous, needle placement
    If 0691T identifies lesions or fractures prompting biopsy or stabilization, CT-guided procedures may follow and be separately coded.