Summary & Overview
CPT 0878T: CT Image Analysis for Interstitial Lung Disease Classification
CPT code 0878T represents a software-assisted analysis of chest CT imaging to classify interstitial lung disease. As imaging-based phenotyping and quantitative analysis tools become more integrated into clinical workflows, this code captures a distinct, reportable service that augments the diagnostic information from the contemporaneous CT scan. The designation matters nationally because it provides a billing pathway for advanced image analysis that supports diagnosis, staging, and management planning for patients with suspected or known interstitial lung disease.
Key payers covered in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise review of the clinical context for image-based classification of interstitial lung disease, an outline of common payer consideration topics for new imaging analytics services, and an explanation of what is typically included in the billed service versus the concurrent CT examination. The publication also summarizes typical sites of service and service type to aid in coding and billing workflow alignment.
This piece is intended to inform billing managers, radiology leaders, and policy analysts about the role of CPT code 0878T in documenting and reimbursing specialized chest CT analysis, and what to expect when implementing or reviewing claims that include this code.
Billing Code Overview
CPT code 0878T describes a service in which the provider uses a specialized software program to analyze chest computed tomography (CT) imaging to classify interstitial lung disease. The CT examination is performed concurrently and is separately reportable.
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Service type: Image analysis/advanced diagnostic interpretation
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Typical site of service: Outpatient radiology or advanced imaging center; may also be provided in hospital radiology departments
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Clinical & Coding Specifications
Clinical Context
A 68-year-old patient with progressive exertional dyspnea and nonproductive cough is referred by a pulmonologist for advanced imaging analysis to aid classification of suspected interstitial lung disease (ILD). The patient undergoes a diagnostic high-resolution chest computed tomography (HRCT) in an outpatient radiology suite or hospital outpatient imaging center. The imaging study is acquired by the radiology team; the provider submits 0878T for use of a specialized software program that analyzes the chest CT to classify ILD patterns (for example usual interstitial pneumonia, nonspecific interstitial pneumonia, organizing pneumonia, or other fibrotic patterns). The CT acquisition is reported separately with the appropriate CT chest CPT code and includes technical components handled by radiology technologists. The specialized program’s interpretation is integrated into the multidisciplinary discussion and clinical decision-making by pulmonology, radiology, and, when applicable, thoracic surgery. Typical sites of service include outpatient imaging centers, hospital outpatient departments, and ambulatory surgical centers when performed as part of pre-procedural evaluation. Common clinical workflow steps: scheduling and preauthorization (if required by payer), CT acquisition, image transfer to the analytic software, software-based analysis and report generation by the interpreting provider, incorporation of results into the final radiology report, and communication to the referring pulmonologist or multidisciplinary ILD team.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
22 | Increased procedural services | Use when the analytic interpretation required substantially greater work or documentation than typical for the service. |
52 | Reduced services | Use when the analytic service was partially reduced or not completed as originally planned. |
53 | Discontinued procedure | Use when the analytic process was started but terminated due to patient or technical factors prior to completion. |
78 | Unplanned return to the operating/procedure room by the same physician following initial procedure for a related procedure during the postoperative period | Rare for this service; use only if unplanned re-intervention related to the analytic procedure occurs intra- or post-procedurally. |
80 | Assistant surgeon | Use if a recognized assistant surgeon or qualified individual performed portions of the technical or analytic procedure as allowed by payer policy. |
82 | Assistant surgeon (when a qualified resident surgeon is unavailable) | Use when an assistant provided services and an approved resident was unavailable. |
AS | Physician assistant, nurse practitioner, or clinical nurse specialist services for surgical care only | Use if an advanced practice provider performed billable elements of the analytic procedure under applicable supervision rules and payer accepts AS. |
TG | Treatment of the patient by a resident under the primary care exception (Medicare GME) — tracking modifier | Use when applicable for resident involvement per institutional billing rules and payer policy. |
| Taxonomy Code | Specialty | Notes |
|---|---|---|
| 2084P0800X | Pulmonary Disease | Pulmonologists order and interpret ILD classification results and integrate findings into clinical management. |
| 207R00000X | Radiology | Diagnostic radiologists perform HRCT acquisition and interpret images; they often review and co-sign software-generated analyses. |
| 207L00000X | Diagnostic Radiology (Thoracic Imaging) | Subspecialty radiologists in thoracic imaging frequently oversee advanced analytic interpretation for ILD. |
| 363A00000X | Clinical Laboratory | Clinical informatics or imaging analysts may manage software platforms and quality control; listed when applicable. |
| 2086S0125X | Pulmonology Critical Care | Pulmonology-critical care physicians participate in multidisciplinary ILD evaluation for complex or hospitalized patients. |
Related Diagnoses
| ICD-10 Code | Description | Clinical Relevance |
|---|---|---|
J84.114 | Idiopathic pulmonary fibrosis | A common fibrotic ILD where CT pattern classification directly affects diagnosis and management. |
J84.10 | Pulmonary fibrosis, unspecified | Used when fibrosis is identified and CT-based classification helps narrow subtype and guide care. |
J84.112 | Pulmonary sarcoidosis | Sarcoidosis can produce interstitial patterns assessed by CT analytic tools to differentiate from other ILDs. |
J84.89 | Other specified interstitial pulmonary diseases | Captures a range of ILD entities for which advanced CT classification aids diagnosis. |
J84.2 | Pulmonary eosinophilia, not elsewhere classified | Includes interstitial processes where CT pattern analysis contributes to differential diagnosis. |
R91.8 | Other nonspecific abnormal finding of lung field | Often used when CT identifies indeterminate findings requiring further classification by analytic software. |
J98.4 | Other disorders of lung, not elsewhere classified | A broader code used when CT analysis supports evaluation of atypical interstitial or parenchymal abnormalities. |
Related CPT Codes
| CPT Code | Description | Relationship to This Procedure |
|---|---|---|
71250 | Computed tomography, thorax; without contrast material | Often billed for the chest CT acquisition that provides images for the analytic program; reported separately from 0878T. |
71260 | Computed tomography, thorax; with contrast material(s)` | Billed when IV contrast is administered for chest CT performed in conjunction with the analytic classification, if clinically indicated. |
71270 | Computed tomography, thorax; without contrast material, followed by contrast material and further sections | Billed when both noncontrast and contrast-enhanced phases are acquired; images may be used by analytic software. |
76376 | 3D rendering with interpretation and reporting of CT, MRI, ultrasound, or other tomographic modality; simple | May be used when additional post-processing or 3D reconstruction supplements the ILD analytic report. |
94640 | Pressurized or non-pressurized inhalation treatment for acute airway obstruction, initial treatment | Included as an example of downstream respiratory therapy procedures in acutely symptomatic patients evaluated for ILD; useful in workflow when respiratory compromise is present. |
31628 | Bronchoscopy, rigid or flexible, with transbronchial lung biopsy, single lobe | Performed in some ILD workups when tissue diagnosis is required; typically performed after imaging and analytic classification informs need for biopsy. |