Summary & Overview
CPT 75635: CTA of Abdominal Aorta and Bilateral Iliofemoral Arteries
CPT code 75635 covers contrast-enhanced computed tomographic angiography (CTA) of the abdominal aorta and both iliofemoral arteries, including any noncontrast images and required postprocessing. This CTA is a key diagnostic tool for assessing aortoiliac and peripheral arterial disease, preoperative vascular planning, and evaluation of suspected aneurysm or arterial occlusive disease. Nationally, accurate use and coding of 75635 affects coverage determinations, prior authorization workflows, and aggregate imaging utilization for cardiovascular and vascular services.
Key payers discussed include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise account of what 75635 represents clinically and operationally, typical sites where the service is performed, and which payers commonly cover or adjudicate this CTA. The publication provides benchmarks for service utilization, notes on billing practices relevant to bundled imaging components, and context for clinical indications driving CTA of the aortoiliac and iliofemoral circulation.
The content aims to inform billing professionals, radiology and vascular service line managers, and policy analysts about coding clarity and common payer considerations for CTA of the abdominal aorta and bilateral iliofemoral arteries using CPT code 75635.
Billing Code Overview
CPT code 75635 describes computed tomographic angiography (CTA) of the abdominal aorta and bilateral iliofemoral arteries with administration of contrast material. The service may include noncontrast images and postprocessing of images performed after completion of the study; those elements are considered part of the CTA and should not be billed separately.
Service type: Imaging — Vascular CTA with contrast
Typical site of service: Hospital outpatient imaging center, outpatient radiology suite, or ambulatory imaging center
Clinical & Coding Specifications
Clinical Context
A 68-year-old male with a history of peripheral arterial disease and increasing claudication is referred from his vascular surgery clinic for imaging to assess the abdominal aorta and iliofemoral arterial segments. The patient reports progressive leg pain with ambulation and diminished ankle-brachial indices on exam. The ordering vascular surgeon requests a computed tomographic angiography (CTA) of the abdominal aorta through the bilateral iliofemoral arteries to define stenosis, occlusion, and arterial anatomy prior to planning endovascular intervention.
The clinical workflow: pre-procedure nursing screening for contrast allergy and renal function (recent serum creatinine), IV access is obtained, informed consent is confirmed, and CT technologist programs the CTA protocol including timing bolus or automated contrast injection. The radiologist administers the iodinated contrast and performs the CTA, including any necessary noncontrast images and postprocessing reconstruction (multiplanar and 3D volume-rendered images). The radiologist interprets the study, dictating findings such as location and severity of atherosclerotic plaque, luminal stenosis, occlusion, aneurysm, or graft status. Images and report are routed to the ordering vascular surgeon for treatment planning.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
26 | Professional component | Use when reporting only the physician interpretation when facility (technical) component billed separately. |