How To Use CPT Code 0635T

CPT 0635T describes the use of computed tomography (CT) to examine a single breast, first without contrast and then with contrast material. This article will cover the description, procedure, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information, and examples.

1. What is CPT Code 0635T?

CPT 0635T can be used to report a CT examination of a single breast, where images are taken both without contrast and with the use of contrast material. This code may also include 3D rendering, although it is not required.

2. Official Description

The official description of CPT code 0635T is: ‘Computed tomography, breast, including 3D rendering, when performed, unilateral; without contrast, followed by contrast material(s).’ It is important to note that this code should not be reported in conjunction with codes 76376, 76377, 76380, or 76497.

3. Procedure

1. The patient is positioned appropriately on the CT equipment.
2. The CT scanner takes multiple cross-sectional images of the single breast.
3. Images are initially taken without the injection of contrast material.
4. The performing individual, such as a radiologic technologist, then injects the patient with contrast material.
5. Additional imaging is performed to capture the contrast-enhanced images.
6. The provider examines the cross-sectional images on a computer monitor and interprets the results.
7. 3D rendering of the images may be performed, providing different complex renderings, image recovery, segmentation, and quantitative analysis.

4. Qualifying circumstances

CPT 0635T is applicable when a CT examination of a single breast is performed, both without contrast and with contrast material. The use of contrast must be intravascular, intraarticular, or intrathecal, as per CPT guidelines. It is important to review the options and select the correct code based on the use of contrast and whether the service is unilateral or bilateral.

5. When to use CPT code 0635T

CPT code 0635T should be used when a CT examination of a single breast is conducted, involving both images without contrast and images with the use of contrast material. It is crucial to ensure that the contrast administered is intravascular, intraarticular, or intrathecal. If the service is bilateral, a different code should be selected.

6. Documentation requirements

To support a claim for CPT code 0635T, the following documentation is necessary:

• Patient’s medical record, including the reason for the CT examination
• Details of the CT procedure, including whether contrast material was used
• Date and time of the examination
• Results and interpretation of the CT images
• Documentation of any 3D rendering performed, if applicable
• Signature of the provider

7. Billing guidelines

When billing for CPT code 0635T, ensure that the CT examination is performed on a single breast, both without contrast and with the use of contrast material. It is important to note that this code should not be reported in conjunction with specific codes (76376, 76377, 76380, or 76497). Additionally, consider the guidelines for reporting contrast administration and select the appropriate code based on the use of contrast and whether the service is unilateral or bilateral.

8. Historical information

CPT code 0635T was added to the Current Procedural Terminology system on January 1, 2021. As of now, there have been no updates or changes to the code since its addition.

9. Examples

1. A radiologic technologist performs a CT examination of a single breast, capturing images both without contrast and with the use of intravascular contrast material.
2. A provider interprets the results of a CT examination of a single breast, which includes 3D rendering, performed by a radiologic technologist.
3. A patient undergoes a CT examination of a single breast, receiving images without contrast and then with the use of intraarticular contrast material.
4. A radiologist reviews the cross-sectional images of a single breast, taken both without contrast and with the use of intrathecal contrast material, to interpret the findings.
5. A CT examination of a single breast is conducted, involving images without contrast and then with the use of intravascular contrast material, by a radiologic technologist.
6. A provider performs a CT examination of a single breast, utilizing both images without contrast and images with the use of intraarticular contrast material, and interprets the results.
7. A patient undergoes a CT examination of a single breast, receiving images without contrast and then with the use of intrathecal contrast material, performed by a radiologic technologist.
8. A radiologist reviews the cross-sectional images of a single breast, taken both without contrast and with the use of intravascular contrast material, to interpret the findings.
9. A CT examination of a single breast is conducted, involving images without contrast and then with the use of intraarticular contrast material, by a radiologic technologist.
10. A provider performs a CT examination of a single breast, utilizing both images without contrast and images with the use of intrathecal contrast material, and interprets the results.