How To Use CPT Code 0637T

CPT 0637T describes the use of computed tomography (CT) with contrast material for a bilateral examination of the breasts, including the option for 3D rendering. This article will provide an overview of the code, including the official description, procedure details, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information, and examples.

1. What is CPT Code 0637T?

CPT 0637T is a code that represents a specific procedure involving the use of CT imaging with contrast material for a bilateral examination of the breasts. This code may also include the option for 3D rendering, although it is not required. It is important to note that CPT codes are used to identify and report specific medical procedures or services provided by healthcare professionals.

2. Official Description

The official description of CPT code 0637T is: ‘Computed tomography, breast, including 3D rendering, when performed, bilateral; with contrast material(s).’ This code indicates that the provider is performing a CT examination of both breasts using contrast material, with the option for 3D rendering if applicable.

3. Procedure

1. The patient is positioned appropriately on the CT equipment.
2. Contrast material is administered to the patient.
3. The CT scanner takes multiple cross-sectional images of both breasts.
4. The provider examines the cross-sectional images on a computer monitor.
5. The provider interprets the results from the images.
6. Optional: 3D rendering of the images may be performed, providing different complex renderings, image recovery, segmentation, and quantitative analysis.

4. Qualifying circumstances

CPT code 0637T is used when a bilateral CT examination of the breasts is performed using contrast material. The contrast material can be administered intravascularly, intraarticularly, or intrathecally. It is important to follow CPT guidelines to ensure the appropriate use of contrast material for reporting purposes.

5. When to use CPT code 0637T

CPT code 0637T should be used when a healthcare provider performs a bilateral CT examination of the breasts using contrast material. This code is specifically for cases where 3D rendering is included. It is important to review the available options and select the correct code based on the use of contrast and whether the service is unilateral or bilateral.

6. Documentation requirements

Documentation for CPT code 0637T should include the following information:

• Patient’s medical history and reason for the CT examination
• Details of the procedure, including the use of contrast material and 3D rendering if applicable
• Date and time of the examination
• Interpretation of the results
• Any additional relevant findings or observations
• Provider’s signature

7. Billing guidelines

When billing for CPT code 0637T, it is important to ensure that the procedure meets the criteria specified in the code description. The use of contrast material and 3D rendering, if applicable, should be documented and supported by medical necessity. It is also important to review any specific guidelines or requirements from insurance payers to ensure accurate and appropriate billing.

8. Historical information

CPT code 0637T was added to the Current Procedural Terminology system on January 1, 2021. As a relatively new code, there have been no updates or changes since its addition.

9. Examples

1. A radiologist performs a bilateral CT examination of the breasts using contrast material and provides 3D rendering for a patient with suspected breast cancer.
2. A surgeon orders a CT scan with contrast for a patient with a breast lump, and the radiology technician performs a bilateral examination with 3D rendering to aid in surgical planning.
3. A patient with a history of breast implants undergoes a routine CT examination of the breasts with contrast material to monitor the integrity of the implants, and 3D rendering is performed to assess any changes or complications.
4. A breast specialist performs a bilateral CT examination with contrast and 3D rendering for a patient with a complex breast abnormality to obtain detailed images for further evaluation and treatment planning.
5. A patient with a family history of breast cancer undergoes a screening CT examination of the breasts with contrast and 3D rendering to assess any potential abnormalities or early signs of disease.
6. A plastic surgeon requests a CT scan with contrast and 3D rendering for a patient considering breast reconstruction surgery to evaluate the breast tissue and plan the surgical procedure.
7. A patient with a history of breast cancer undergoes a follow-up CT examination with contrast and 3D rendering to monitor the effectiveness of treatment and detect any recurrence or metastasis.
8. A healthcare provider orders a CT scan with contrast and 3D rendering for a patient with breast pain and swelling to assess for any underlying causes or abnormalities.
9. A patient with a suspected breast abscess undergoes a CT examination with contrast and 3D rendering to aid in the diagnosis and guide the appropriate treatment approach.
10. A patient with a known breast abnormality undergoes a CT examination with contrast and 3D rendering to obtain detailed images for further evaluation and determine the need for additional interventions.