Summary & Overview
CPT 73201: CT of Upper Extremity With Contrast
CPT code 73201 covers computed tomography (CT) of the upper extremity performed with contrast to evaluate vascular, soft-tissue, and osseous pathology. Nationally, this imaging modality is widely used in trauma evaluation, infection assessment, tumor staging, and preoperative planning, making accurate coding and coverage determinations important for access and payment consistency. Major commercial and public payers use distinct medical necessity and prior authorization policies that affect utilization and claim adjudication for contrast-enhanced upper-extremity CT.
Key payers discussed include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise overview of what CPT code 73201 represents, where the service is typically delivered, and which payers commonly cover it. The publication outlines benchmark considerations, common billing modifiers and administrative considerations (where provided), and the clinical contexts in which the study is ordered.
This summary equips billing managers, radiology administrators, and policy analysts with a national-level briefing on coding and coverage relevance for contrast-enhanced CT of the upper extremity, including expected sites of service and the clinical scenarios driving use. Data not available in the input is noted where applicable.
Billing Code Overview
CPT code 73201 describes a computer tomographic (CT) imaging study of the upper extremity performed with contrast. This service involves acquisition of CT images of structures such as the shoulder, arm, elbow, forearm, wrist, or hand with intravenous or intra-arterial contrast to enhance visualization of vascular structures, soft tissues, and bone detail.
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Service type: Diagnostic advanced imaging (CT with contrast)
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Typical site of service: Outpatient imaging center or hospital outpatient department
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Clinical & Coding Specifications
Clinical Context
A 52-year-old right-hand–dominant patient presents to the outpatient imaging center with persistent wrist pain and swelling following a fall onto an outstretched hand three weeks earlier. Prior radiographs were inconclusive for intra-articular fracture or ligamentous injury. The referring orthopedic surgeon requests cross-sectional vascular and soft-tissue assessment of the distal upper extremity to evaluate for occult fracture, intra-articular pathology, and contrast-enhancing soft-tissue injury.
The clinical workflow: the patient registers at the radiology front desk, screening for contrast allergies and renal function; intravenous access is obtained; informed consent for iodinated contrast is secured; a diagnostic computer tomography (CT) angiographic and contrast-enhanced protocol of the upper extremity is performed by a CT technologist under radiologist supervision; the radiologist interprets axial and reformatted images and issues a final report to the referring provider. Typical sites of service include hospital outpatient radiology departments and independent imaging centers.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
26 | Professional component | Use when only the physician interpretation/report is billed separately from the technical imaging component |