CPT® Code 0638T

Official Description

Computed tomography, breast, including 3D rendering, when performed, bilateral; without contrast, followed by 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 such as mammography. 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 amount of radiation absorbed by the breast tissue. This information is then processed by a computer program, which generates two-dimensional (2D) cross-sectional images that are displayed on a monitor for analysis. In cases where 3D rendering is performed, the CT images can be further enhanced to provide a more comprehensive view of the breast anatomy. This may involve techniques such as shaded surface rendering, volumetric rendering, maximum intensity projections (MIPs), fusion imaging, and quantitative analysis, all of which contribute to a more thorough understanding of the breast tissue's structure and any potential abnormalities. The procedure is coded as CPT® Code 0638T when it is performed without intravenous contrast initially, followed by the administration of contrast material for additional imaging. This coding distinction is important for accurate billing and documentation. After the scan, the physician reviews the images, identifies any abnormalities, and prepares a written interpretation of the findings, which is essential for guiding further clinical decisions and patient management.

1. Indications

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

Evaluation of Abnormalities This procedure is indicated for the assessment of any detected abnormalities in breast tissue, which may include masses, calcifications, or other suspicious findings that require further investigation.
High-Risk Screening Patients with a high risk of breast cancer, such as those with a family history or genetic predisposition, may be referred for CT imaging to monitor breast health more closely.
Assessment of Treatment Response CT scans can be utilized to evaluate the effectiveness of ongoing treatment for breast cancer, allowing for adjustments in therapy based on the imaging findings.

2. Procedure

The procedure for performing a CT scan of the breast involves several key steps:

Initial Positioning The patient is positioned on the examination table in a manner that allows for optimal imaging of both breasts. This positioning is crucial for obtaining accurate and comprehensive images.
Initial Scan An initial pass through the CT scanner is conducted to determine the starting position for the imaging process. This step ensures that the subsequent scans are aligned correctly for accurate data collection.
CT Imaging As the examination table moves slowly through the scanner, multiple X-ray beams and detectors rotate around the breasts. The system measures the amount of radiation absorbed by the breast tissue, capturing detailed imaging data.
Image Processing The data collected during the scan is processed by a computer program, which generates two-dimensional (2D) cross-sectional images of the breast tissue. These images are displayed on a monitor for immediate review.
3D Rendering (if performed) If 3D rendering is indicated, complex imaging techniques are applied to the 2D images. This may include shaded surface rendering, volumetric rendering, maximum intensity projections (MIPs), and fusion imaging, providing a more detailed view of the breast anatomy.
Contrast Administration In cases where CPT® Code 0638T is applicable, contrast material is administered after the initial imaging without contrast. This allows for the acquisition of additional sections that enhance the diagnostic quality of the images.
Review and Interpretation After the imaging is complete, the physician reviews the CT scan results, notes any abnormalities, and prepares a written interpretation of the findings, which is essential for clinical decision-making.

3. Post-Procedure

Post-procedure care following a CT scan of the breast typically involves monitoring the patient for any immediate reactions to the contrast material, if administered. Patients may be advised to drink plenty of fluids to help flush the contrast from their system. The physician will provide the patient with information regarding the timing of results and any necessary follow-up appointments based on the findings of the CT scan. It is important for patients to discuss any concerns or symptoms they may experience after the procedure with their healthcare provider.

Short Descr	CT BREAST W/3D BI C-/C+
Medium Descr	CT BRST W/3D RENDERING BI WO CNTRST FLWD CNTRST
Long Descr	Computed tomography, breast, including 3D rendering, when performed, bilateral; without contrast, followed by 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