Summary & Overview
CPT 71250: CT Scan of Thorax Without Contrast
CPT code 71250 is a widely utilized billing code for computed tomography (CT) scans of the thorax performed without contrast material. This diagnostic imaging procedure is essential for evaluating a range of chest conditions, including lung disorders, abnormal findings in the lung field, chronic obstructive pulmonary disease, shortness of breath, and chest pain. The code is recognized by major national payers, including Aetna, Blue Cross Blue Shield, Cigna Health, Medicare, and UnitedHealthcare, ensuring broad coverage across the healthcare landscape.
This publication provides a comprehensive overview of 71250, including payer coverage, clinical context, and related billing practices. Readers will gain insight into the procedure's role in diagnostic radiology, typical clinical indications, and how it fits within the broader spectrum of chest imaging services. The analysis also highlights associated modifiers, relevant physician taxonomies, and related CPT codes for thoracic imaging. Key benchmarks and policy updates are discussed to inform stakeholders about current trends and requirements in medical billing for chest CT scans. The information is designed to support healthcare professionals, administrators, and policy analysts in understanding the national significance and operational details of this procedure.
CPT Code Overview
CPT code 71250 represents a computed tomography (CT) scan of the thorax performed without the use of contrast material. This procedure is classified under Diagnostic Radiology (Diagnostic Imaging) Procedures of the Chest. It is commonly used to evaluate the lungs, mediastinum, and chest wall for a variety of clinical indications. The typical site of service for this procedure is not explicitly documented in the available sources. CT imaging of the thorax without contrast is a standard diagnostic tool in medical practice, providing detailed cross-sectional images to assist in the assessment of chest conditions.
Clinical & Coding Specifications
Clinical Context
A patient presents with symptoms such as shortness of breath, chest pain, or abnormal findings on a chest X-ray. The clinician orders a computed tomography (CT) scan of the thorax without contrast material to further evaluate the lungs and chest structures. The procedure is performed by a radiology team, and the images are interpreted by a diagnostic radiologist. This workflow is typical for patients with suspected lung disorders, chronic obstructive pulmonary disease, or nonspecific abnormal findings in the chest.
Coding Specifications
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Modifier
26: Used to indicate the professional component, which covers the interpretation and reporting of the CT scan by the radiologist. -
Modifier
TC: Used to indicate the technical component, which covers the use of equipment, supplies, and technical staff for performing the CT scan.
| Modifier Code | Description |
|---|---|
26 | Professional Component |