CPT 73202 CT Upper Extremity Reimbursement | OpenPayer

Summary & Overview

CPT 73202: CT Upper Extremity, Without and With Contrast

CPT code 73202 denotes CT imaging of the upper extremity performed in two phases: an initial non-contrast acquisition followed by a contrast-enhanced acquisition. This dual-phase study provides comprehensive anatomic and vascular detail useful for assessing trauma, infection, inflammatory disorders, neoplasm, and vascular compromise in the shoulder, arm, elbow, forearm, wrist, or hand. Nationally, accurate coding for combined non-contrast and contrast CT studies affects utilization tracking, payment adjudication, and clinical decision support for advanced imaging.

Key payers covered in this overview include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise explanation of the clinical purpose and typical sites of service for the procedure, common modifier usage where available, and an outline of areas that influence billing and claims processing. The publication summarizes benchmark considerations, payer coverage patterns, and operational notes relevant to imaging departments and billing teams. It also highlights clinical contexts in which dual-phase CT of the upper extremity is frequently ordered and the implications for documentation and imaging protocol selection. Data not available in the input are noted where applicable.

AetnaBlue Cross Blue ShieldCigna HealthUnitedHealthcareMedicare73202CPTCT imagingupper extremitydiagnostic radiologycontrast-enhanced CTimaging protocoloutpatient imaging

Billing Code Overview

CPT code 73202 describes a computed tomographic (CT) imaging procedure of the upper extremity performed twice: first without contrast and then repeated after intravenous contrast material is administered. This diagnostic CT imaging captures both non-contrast and contrast-enhanced phases to evaluate bones, joints, soft tissues, and vascular structures of the upper limb.

Service type: Diagnostic imaging — CT of the upper extremity, with and without contrast

Typical site of service: Outpatient radiology department, hospital imaging center, or ambulatory imaging facility

Clinical & Coding Specifications

Clinical Context

A 54-year-old right-handed patient presents to the outpatient imaging center with persistent wrist pain and intermittent paresthesias following a fall six weeks earlier. The referring orthopedic surgeon requests advanced imaging to evaluate for occult fracture, intra-articular joint pathology, and suspected vascular or soft-tissue abnormality. The patient is screened for contrast allergy and renal function; peripheral IV access is established for contrast administration. The CT technologist performs a noncontrast axial CT of the affected upper extremity (wrist and distal forearm), followed by intravenous iodinated contrast injection and timed post-contrast imaging of the same region to assess enhancement patterns of soft tissues, vascular structures, and potential infection or tumor. The interpreting radiologist reviews both noncontrast and contrast-enhanced series, documents comparison with prior radiographs, and provides a structured report with findings and impressions for the referring provider. Typical sites of service are hospital outpatient imaging departments, freestanding radiology centers, or ambulatory surgery centers equipped for CT with contrast capabilities. The anticipated workflow includes patient registration, consent for contrast, pre-scan screening, image acquisition (noncontrast then contrast-enhanced), image reconstruction, radiologist interpretation, and electronic report delivery to the referring clinician.

Coding Specifications

Modifier	Description	When to Use
`26`	Professional component

CPT 73080: Elbow X‑ray, Minimum 3 Views

CPT-73040-SHOULDER-ARTHROGRAM-IMAGING-INTERPRETATION

CPT 73040: Shoulder Arthrogram Imaging Supervision and Interpretation

CPT-73010-SCAPULA-XRAY-COMPLETE-STUDY

CPT 73010: Scapula X‑ray, Complete

CPT-73020-SINGLE-VIEW-SHOULDER-XRAY

CPT 73020: Single View X‑ray of the Shoulder

CPT-73206-CT-ANGIOGRAPHY-UPPER-EXTREMITY

CPT 73206: CT Angiography of Upper Extremity

CPT-73201-CT-UPPER-EXTREMITY-WITH-CONTRAST

CPT 73201: CT of Upper Extremity With Contrast

CPT-73100-WRIST-XRAY-TWO-VIEWS

CPT 73100: Two-View Radiographic Examination of the Wrist

CPT-73115-WRIST-ARTHROGRAM-IMAGING-INTERPRETATION

CPT 73115: Wrist Arthrogram Imaging Supervision and Interpretation

73110-RADIOLOGIC-EXAMINATION-WRIST-COMPLETE-MINIMUM-OF-3

CPT 73110: Radiologic Examination of Wrist, Complete (≥3 Views)

CPT-73085-ELBOW-ARTHROGRAPHY-IMAGING-INTERPRETATION

CPT 73085: Elbow Arthrography, Imaging Supervision and Interpretation

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Taxonomy Code	Specialty	Notes
`2084P0800X`	Diagnostic Radiology	Most common specialty performing CT imaging of the upper extremity.
`207K00000X`	Orthopedic Surgery	Referring specialty that commonly orders CT for fracture or joint evaluation.
`207L00000X`	Hand Surgery	Specialty focused on complex wrist/hand pathology requiring CT assessment.
`208D00000X`	Emergency Medicine	May perform or order CT in acute trauma presentations for triage and diagnosis.
`2086S0102X`	Vascular Surgery	May request contrast-enhanced CT for vascular injury or occlusive disease evaluation.

Related Diagnoses

ICD-10 Code	Description	Clinical Relevance
`S62.81XA`	Fracture of other parts of wrist, initial encounter for closed fracture	CT with and without contrast helps detect occult or complex wrist fractures not evident on radiographs.
`M25.531`	Pain in right wrist	Symptom code prompting advanced imaging when persistent pain suggests structural pathology.
`M25.532`	Pain in left wrist	Same clinical relevance for the contralateral wrist.
`M79.643`	Pain in right hand	CT can evaluate adjacent hand structures and soft tissues when pain source is unclear.
`M79.644`	Pain in left hand	As above for the left side.
`S67.90XA`	Unspecified injury of forearm, initial encounter	Trauma-related code leading to CT to assess soft-tissue injury, foreign body, or vascular compromise.
`M86.60`	Osteomyelitis, unspecified site	Contrast-enhanced CT can help evaluate bone infection extent and adjacent soft-tissue involvement.
`C40.9`	Malignant neoplasm of bone and articular cartilage of limb, unspecified	Contrast-enhanced imaging may be used to assess suspected bone tumors or metastatic disease in the upper extremity.

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`73200`	Computed tomography, upper extremity; without contrast material	Performed when only noncontrast imaging is required; often performed first as part of `73202`.
`73201`	Computed tomography, upper extremity; with contrast material(s)	Performed when only contrast-enhanced imaging is required; represents the contrast portion of `73202` when billed separately.
`70450`	CT head/brain without contrast	Sometimes performed in multi-region trauma workups when head injury is suspected alongside upper extremity trauma.
`73000`	Radiologic examination, shoulder; complete, minimum of two views	Plain radiographs frequently precede CT to screen for obvious fractures and guide need for CT.
`96365`	Intravenous infusion for therapeutic, prophylactic, or diagnostic contrast (up to 1 hour)	Captures administration of intravenous contrast in some billing contexts when required by payer; documents contrast infusion services related to CT.

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