CPT® Code 0637T

Official Description

Computed tomography, breast, including 3D rendering, when performed, bilateral; with contrast material(s)

Common Language Description

Computed tomography (CT) of the breast is a sophisticated imaging technique that utilizes advanced X-ray technology and computer processing to create detailed cross-sectional images of both breasts. This procedure is particularly valuable in the evaluation of breast tissue, allowing for the identification of abnormalities that may not be visible through traditional imaging methods. During the CT scan, the patient is carefully positioned on an examination table, and an initial scan is conducted to establish the appropriate starting position for the imaging process. As the table gradually moves through the CT scanner, a series of X-ray beams and detectors rotate around the area being examined, capturing data on the varying levels of radiation absorption by the breast tissue. This information is then processed by a specialized computer program, which generates two-dimensional (2D) cross-sectional images that are displayed on a monitor for analysis. When indicated, the procedure may also include three-dimensional (3D) rendering, which enhances the visualization of the breast structures. This advanced rendering can involve techniques such as shaded surface rendering, volumetric rendering, maximum intensity projections (MIPs), fusion imaging, and quantitative analysis, providing a comprehensive view of the breast anatomy. It is important to note that CPT® Code 0637T is specifically used when intravenous contrast material is administered prior to the CT scan, enhancing the visibility of certain tissues and potential abnormalities. In contrast, CPT® Code 0636T is designated for CT scans performed without intravenous contrast, while CPT® Code 0638T applies when a CT scan is initially conducted without contrast, followed by the administration of contrast for additional imaging. After the completion of the scan, the physician reviews the images, identifies any potential issues, and prepares a written interpretation of the findings for further evaluation and management.

1. Indications

The indications for performing a computed tomography (CT) scan of the breast with contrast material include the following:

Evaluation of Breast Abnormalities This procedure is indicated for patients presenting with palpable lumps, changes in breast shape or size, or other abnormalities detected during a physical examination or through mammography.
Assessment of Tumors CT scans are utilized to assess the size, shape, and extent of breast tumors, aiding in the determination of the appropriate treatment plan.
Monitoring Treatment Response This imaging technique may be indicated for monitoring the effectiveness of ongoing treatment for breast cancer or other breast conditions.
Preoperative Planning CT imaging can assist surgeons in planning for breast surgery by providing detailed anatomical information.

2. Procedure

The procedure for a computed tomography (CT) scan of the breast with contrast material involves several key steps:

Patient Positioning The patient is positioned comfortably on the examination table, ensuring that both breasts are adequately accessible for imaging. Proper positioning is crucial for obtaining high-quality images.
Initial Scan An initial pass through the CT scanner is performed to determine the starting position for the imaging. This step is essential for ensuring that the entire area of interest is captured during the scan.
Administration of Contrast Material Intravenous contrast material is administered to enhance the visibility of the breast tissue. This contrast helps to differentiate between normal and abnormal tissues during the imaging process.
CT Scanning As the examination table moves slowly through the CT scanner, multiple X-ray beams and detectors rotate around the breasts. The scanner captures data on the amount of radiation absorbed by the breast tissue, which is critical for image formation.
Image Processing The data collected during the scan is processed by a computer program, which generates two-dimensional (2D) cross-sectional images of the breasts. These images are displayed on a monitor for immediate review.
3D Rendering (if performed) If indicated, complex 3D rendering techniques are applied to the 2D images. This may include shaded surface rendering, volumetric rendering, maximum intensity projections (MIPs), and fusion imaging, providing a comprehensive view of the breast anatomy.
Review and Interpretation After the imaging is complete, the physician reviews the CT scan images, identifies any abnormalities, and prepares a written interpretation of the findings for further clinical decision-making.

3. Post-Procedure

Post-procedure care following a computed tomography (CT) scan of the breast with contrast material typically involves monitoring the patient for any immediate reactions to the contrast agent. Patients may be advised to drink plenty of fluids to help flush the contrast material from their system. It is also important for the physician to communicate the results of the CT scan to the patient in a timely manner, discussing any findings and potential next steps in their care. Patients should be informed about any follow-up appointments or additional imaging that may be necessary based on the results of the CT scan.

Short Descr	CT BREAST W/3D BI C+
Medium Descr	CT BREAST W/3D RENDERING BI WITH CONTRAST
Long Descr	Computed tomography, breast, including 3D rendering, when performed, bilateral; with contrast material(s)
Status Code	Carriers Price the Code
Global Days	XXX - Global Concept Does Not Apply
PC/TC Indicator (26, TC)	1 - Diagnostic Tests for Radiology Services
Multiple Procedures (51)	0 - No payment adjustment rules for multiple procedures apply.
Bilateral Surgery (50)	3 - The usual payment adjustment for bilateral procedures does not apply.
Physician Supervisions	09 - Concept does not apply.
Assistant Surgeon (80, 82)	0 - Payment restriction for assistants at surgery applies to this procedure...
Co-Surgeons (62)	0 - Co-surgeons not permitted for this procedure.
Team Surgery (66)	0 - Team surgeons not permitted for this procedure.
Diagnostic Imaging Family	99 - Concept Does Not Apply
APC Status Indicator	Codes That May Be Paid Through a Composite APC
ASC Payment Indicator	Radiology service paid separately when provided integral to a surgical procedure on ASC list; payment based on OPPS relative payment weight.
Berenson-Eggers TOS (BETOS)	none
MUE	1