CPT 71270: CT Thorax, Without and With Contrast

CPT code 71270 represents a CT scan of the thorax performed without contrast followed by contrast-enhanced imaging during the same session. This dual-phase CT study is used to evaluate pulmonary parenchyma, mediastinal structures, pleura, and vascular anatomy with both native and contrast-enhanced views, improving diagnostic sensitivity for lesions, vascular processes, and inflammatory conditions. Nationally, accurate reporting of this code affects imaging utilization, clinical pathways for chest disease evaluation, and facility billing for combined non-contrast and contrast CT services. Key payers in typical analyses include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare.

Readers will find: clinical context for when a combined non-contrast and contrast chest CT is performed; common sites of service and service type classification; typical payer coverage considerations and common modifier use (listed separately); and benchmarking and policy topics relevant to imaging utilization and documentation. Data not available in the input is noted where payer-specific reimbursement amounts, associated taxonomies, and ICD-10 linkage would normally appear. This publication focuses on national-level implications for coding, clinical interpretation, and administrative considerations for CPT code 71270.

Billing Code Overview

CPT code 71270 describes a computed tomography (CT) examination of the thorax performed first without contrast and then with contrast during the same encounter. The study includes acquisition of non-contrast images followed by intravenous contrast administration and additional contrast-enhanced imaging to provide both native and enhanced evaluation of thoracic structures.

Service type: Diagnostic imaging, CT of the chest with and without contrast
Typical site of service: Radiology departments, hospital outpatient imaging centers, and freestanding imaging centers where CT imaging with intravenous contrast is performed

Clinical Context

A typical patient is an adult presenting to the emergency department or outpatient imaging center with acute chest pain, shortness of breath, unexplained cough, or suspected pulmonary embolism. The provider orders a CT of the thorax without contrast followed immediately by contrast-enhanced imaging (71270) to evaluate both native lung parenchyma and vascular structures. The workflow includes triage and screening for contrast allergies and renal function, IV placement, noncontrast CT acquisition, administration of iodinated contrast, contrast-enhanced CT acquisition, image reconstruction, and radiologist interpretation. Typical sites of service are hospital outpatient imaging facilities, emergency departments, and freestanding radiology centers. Common clinical indications include evaluation for pulmonary embolism, trauma to the chest, characterization of pulmonary nodules, and assessment of acute infectious or inflammatory lung disease.

Coding Specifications

Modifier	Description	When to Use
`26`	Professional component	When billing only the interpreting physician's work separate from the technical component
`TC`

Taxonomy Code	Specialty	Notes
`207RH0000X`	Radiology — Diagnostic Radiology	Primary specialty performing thoracic CT interpretation and supervision
`2085R0201X`	Emergency Medicine	Orders and often initiates CT in acute presentations
`207L00000X`	Pulmonary Disease	Refers patients for lung-specific imaging and follow-up
`2084P0800X`	Hospitalist	Orders inpatient imaging for acutely hospitalized patients
`363A00000X`	Vascular Surgery	May request CT angiographic evaluation when vascular injury or PE suspected

Related Diagnoses

ICD-10 Code	Description	Clinical Relevance
`I26.99`	Other pulmonary embolism without acute cor pulmonale	CT with and without contrast is commonly used to evaluate for pulmonary embolism
`R07.9`	Chest pain, unspecified	Noncontrast and contrast CT may be used when chest pain etiology is unclear and further anatomic detail is required
`R06.02`	Shortness of breath	Imaging of the thorax assesses causes such as pneumonia, effusion, or embolus
`J18.9`	Pneumonia, unspecified organism	CT can further characterize extent of infection and complications
`S27.9XXA`	Injury of thorax, unspecified, initial encounter	Trauma evaluation often includes CT of the chest with and without contrast

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`71260`	CT thorax, without contrast material only	Performed when only noncontrast imaging is needed; `71270` includes both noncontrast and contrast acquisitions
`71275`	CT thorax, with contrast material, including noncontrast when performed; perfusion unavailable	Alternative code when contrast-only or combined acquisition reporting rules differ; may be used depending on payer coding guidance
`74177`	CT abdomen and pelvis with contrast, including noncontrast when performed	Often performed in combination when evaluating thoracoabdominal trauma or suspected metastatic disease
`70450`	CT head/brain without contrast	May be performed in multi-region trauma workups alongside chest CT
`71045`	Radiologic examination, chest; single view	Plain chest radiograph frequently precedes CT as an initial imaging test

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Summary & Overview