How To Use CPT Code 71260

CPT 71260 refers to a diagnostic computed tomography (CT) scan of the thorax using contrast material. This article will cover the description, procedure, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information, similar codes, and examples of CPT code 71260 procedures.

1. What is CPT 71260?

CPT 71260 is a diagnostic procedure code used to describe a computed tomography (CT) examination of the thorax using contrast material. This code is utilized by healthcare providers to accurately document and bill for this specific type of diagnostic imaging service.

2. 71260 CPT code description

The official description of CPT code 71260 is: “Computed tomography, thorax, diagnostic; with contrast material(s)”.

3. Procedure

1. The patient is positioned appropriately on the scanner bed.
2. The patient is instructed to remain motionless during the procedure.
3. A contrast agent is injected into the patient, typically through a vein in the upper extremity.
4. The scanner bed moves slowly into the scanner, and multiple cross-sectional images of the thoracic region are taken.
5. The provider examines the cross-sectional images on a computer monitor and interprets the diagnostic results.
6. The computer stores, reconstructs, and reproduces the images as prints for further evaluation as necessary.

4. Qualifying circumstances

Patients who are eligible to receive CPT code 71260 services are those who require a diagnostic CT scan of the thorax with contrast material. This may include patients with suspected or known thoracic abnormalities, such as tumors, infections, or vascular conditions. The contrast material helps to enhance the visibility of certain structures within the thorax, allowing for a more accurate diagnosis.

5. When to use CPT code 71260

It is appropriate to bill the 71260 CPT code when a healthcare provider performs a diagnostic CT scan of the thorax using contrast material. This code should be used only when the contrast material is administered intravascularly, intraarticularly, or intrathecally. Oral or rectal contrast administration should be coded as without contrast.

6. Documentation requirements

To support a claim for CPT 71260, the following information should be documented:

• Indication for the CT scan (e.g., suspected or known thoracic abnormality)
• Type and route of contrast material administration
• Details of the CT scan procedure, including patient positioning and instructions
• Findings and interpretation of the diagnostic results
• Any complications or adverse reactions related to the procedure or contrast material

7. Billing guidelines

When billing for CPT code 71260, it is important to follow payer-specific guidelines and policies. Providers who supply contrast may also separately report the contrast using a 99070 supply code or a HCPCS Level II code, depending on the payer’s policy. If reporting only the physician’s interpretation for the radiology service, append professional component modifier 26 to the radiology code. If reporting only the technical component, append modifier TC to the radiology code. Do not append a professional or technical modifier when reporting a global service in which one provider renders both components.

8. Historical information

CPT 71260 was added to the Current Procedural Terminology system on January 1, 1990. The code has undergone two changes since its addition:

• Code Changed on 01-01-2003: “Computerized axial tomography, thorax; with contrast material(s)”
• Code Changed on 01-01-2021: “Computed tomography, thorax; with contrast material(s)”

9. Similar codes to CPT 71260

Five similar codes to CPT 71260 and how they differentiate are:

1. CPT 71250: CT scan of the thorax without contrast material
2. CPT 71270: CT scan of the thorax without contrast material, followed by contrast material and further sections
3. CPT 71275: CT angiography of the thorax with contrast material, including 3D image post-processing
4. CPT 70490: CT scan of the soft tissue of the neck with contrast material
5. CPT 70491: CT scan of the soft tissue of the neck without contrast material, followed by contrast material and further sections

10. Examples

Here are 10 detailed examples of CPT code 71260 procedures:

1. A patient with a suspected lung tumor undergoes a CT scan of the thorax with intravenous contrast material to aid in diagnosis.
2. A patient with a history of pulmonary embolism receives a CT scan of the thorax with contrast material to evaluate for recurrent emboli.
3. A patient with chest pain and a suspected aortic dissection undergoes a CT scan of the thorax with contrast material to visualize the aorta.
4. A patient with a known mediastinal mass receives a CT scan of the thorax with contrast material to assess the extent of the mass and its relationship to surrounding structures.
5. A patient with a history of tuberculosis undergoes a CT scan of the thorax with contrast material to evaluate for active disease or complications.
6. A patient with a suspected thoracic vascular malformation receives a CT scan of the thorax with contrast material to delineate the abnormality.
7. A patient with a history of lymphoma undergoes a CT scan of the thorax with contrast material to assess for disease recurrence or progression.
8. A patient with a suspected pleural effusion receives a CT scan of the thorax with contrast material to confirm the presence and extent of the effusion.
9. A patient with a history of chest trauma undergoes a CT scan of the thorax with contrast material to evaluate for injuries to the thoracic organs and structures.
10. A patient with a suspected bronchial abnormality receives a CT scan of the thorax with contrast material to visualize the bronchial tree and surrounding structures.