CPT® Code 71275

Quick Reference

• Code definition: CPT 71275 covers CT angiography of the noncoronary thoracic vessels (pulmonary arteries, thoracic aorta, great vessels) performed with IV contrast, with image postprocessing and noncontrast images (if obtained) bundled into the code.
• Key billing rule: MUE = 1 per date of service. CPT 71275 is mutually exclusive with 71250, 71260, and 71270 on the same date of service for the same anatomic region; NCCI bundles all four.
• Modifier essentials: Modifiers TC (technical component, facility or imaging center) and 26 (professional component, interpreting radiologist) apply under PC/TC indicator 1. Modifier 50 does NOT apply (bilateral indicator = 0); the thorax is inherently bilateral by definition.
• Documentation must-have: The acquisition record and radiology report must document a CTA-specific protocol (bolus-tracking trigger, test-bolus timing, or named CTA protocol). Without it, the correct code is 71260, not 71275.
• Top confusion point: 76376 and 76377 are never separately billable with 71275. CPT parenthetical instructions under both codes explicitly prohibit separate reporting when postprocessing is bundled in a CT angiography code [5].
• Payer alert: There is no National Coverage Determination for CTA chest. Coverage is MAC-specific via local LCDs; verify the applicable LCD by jurisdiction before submitting [2].

When to Use This Code

CPT 71275 applies when a dedicated CT angiographic acquisition of the noncoronary thoracic vasculature is performed. The key word is "dedicated": the scan must use vascular-phase contrast timing (bolus-tracking, test bolus, or automated triggering) designed to opacify the pulmonary arteries, thoracic aorta, or other noncoronary structures at peak enhancement.

Clinical indications per ACR Appropriateness Criteria [6]:

• Suspected acute pulmonary embolism (CTPA is the standard-of-care first-line imaging test)
• Suspected thoracic aortic dissection, intramural hematoma, or penetrating aortic ulcer
• Thoracic aortic aneurysm: initial characterization or surveillance
• Blunt thoracic trauma with suspected great vessel injury
• Pre-operative planning for TAVR, TEVAR, or other thoracic vascular interventions
• Post-TEVAR surveillance
• Pulmonary arteriovenous malformation (PAVM) evaluation
• Mediastinal vascular abnormalities (SVC syndrome, congenital variants)

Scope boundaries: The "(noncoronary)" qualifier in the descriptor is a hard boundary. If the clinical target is the coronary arteries (cardiac-gated CTA), report 75574, not 71275. Studies evaluating both the thoracic aorta and pulmonary arteries still fall under 71275 because both are noncoronary structures. No "without contrast" variant of 71275 exists; contrast is always required.

Setting and provider: Most facilities split billing between TC (hospital or imaging center) and 26 (interpreting radiologist). An independent physician who owns the scanner and reads the study reports the global service without a modifier. The code is payable in the ASC setting, with reimbursement based on OPPS relative payment weights [5].

Code Differentiation Table

The single most critical differentiator is acquisition protocol, not clinical question. A study ordered to rule out aortic aneurysm but scanned with standard 70-second portal venous timing is correctly reported as 71260. Documentation of bolus-tracking notation or a named CTA protocol in the acquisition parameters is what distinguishes 71275 from 71260 at audit [5].

flowchart TD
    A[CT of the chest ordered with contrast] --> B{Dedicated CTA vascular-phase protocol?}
    B -- No: parenchymal phase timing --> C{Pre-contrast phase also acquired?}
    C -- No --> D[71260: CT thorax with contrast]
    C -- Yes --> E[71270: CT thorax without and with contrast]
    B -- Yes: bolus-tracking or test-bolus --> F{Target: coronary arteries?}
    F -- Yes: cardiac-gated coronary CTA --> G[75574: CTA heart]
    F -- No: pulmonary arteries, aorta, great vessels --> H[71275: CTA chest noncoronary]

Billing & Modifier Rules

Modifiers TC and 26: PC/TC indicator 1 confirms that CTA chest is a diagnostic radiology service subject to component billing. Hospitals and imaging centers report 71275-TC. Interpreting radiologists report 71275-26. Inadvertent duplicate global billing by both the facility and the radiologist group is a common compliance error; each entity must apply the correct modifier [5].

Modifier 50 does not apply: Bilateral indicator = 0. CTA chest images bilateral pulmonary structures and bilateral thoracic vasculature by design; appending modifier 50 is incorrect and will generate a claim edit.

Modifier 59 / XU: When 71275 is billed on the same date as another distinct vascular CTA for a different anatomic region (for example, 74175 for aortic dissection extending below the diaphragm), modifier 59 or XU on the lower-valued code documents distinct separate acquisitions.

Modifier 52: If a study is incomplete due to patient condition (for example, IV access failure before full CTA acquisition), modifier 52 (reduced services) may apply with supporting documentation.

MUE = 1: Only one unit of 71275 is payable per date of service per beneficiary. Additional units deny automatically [2].

Bundling with 76376/76377: CPT parenthetical instructions under 76376 and 76377 explicitly state these codes are not separately reportable when postprocessing is included in the CT angiography code [5]. MIP reconstructions, 3D volume rendering, and curved MPR generated from the CTA dataset are all bundled. This is a hard CPT rule, not a payer preference.

Multiple Diagnostic Imaging Reduction (indicator 4): When 71275 is billed on the same date as another code from Diagnostic Imaging Family 88 (71250, 71260, or 71270) for the same patient, the TC of the lower-valued procedure is reduced by 50%. The professional component is not subject to this reduction [5].

Documentation Essentials

Per CMS Medicare Claims Processing Manual, Chapter 13 (Radiology) [1], the record must support both medical necessity and the specific code reported.

Required elements for 71275:

• Written or electronic order from the treating physician with a specific clinical indication (not generic "CT chest with contrast")
• Acquisition parameters documenting CTA-specific technique: bolus-tracking trigger threshold, test-bolus timing, or named CTA protocol (for example, "CTPA protocol" or "CTA thoracic aorta protocol")
• IV contrast documentation: agent, volume, and injection rate
• If noncontrast phase was obtained, document in the report (included in 71275; no separate code)
• Interpretation report with radiologist signature, vascular structures evaluated, clinical question addressed, and relevant measurements (PE clot burden, aortic diameter at key levels)
• Specific list of postprocessing performed (MIP, 3D VR, curved MPR) to support the bundled postprocessing component
• Explicit statement that the study evaluates noncoronary thoracic vessels (for example, "CTA of the thoracic aorta and pulmonary arteries" rather than "CT chest with contrast")

Audit red flags specific to 71275:

• Report language matching a standard contrast CT without reference to CTA protocol or vascular-phase timing: auditors flag this as potential upcoding of 71260 to 71275
• Absence of bolus-tracking or timing data in acquisition parameters
• 76376 or 76377 billed alongside 71275: triggers CPT parenthetical violation review
• Modifier 50 appended: indicates unfamiliarity with the bilateral indicator rule
• Diagnosis code I71.2 submitted: deleted FY2023; claim will reject [4]

Medicare, Commercial & Medicaid Payer Rules

Medicare:

CMS has not issued a National Coverage Determination for CTA chest. Coverage is determined by MAC-issued Local Coverage Determinations; search the CMS Medicare Coverage Database for code 71275 by jurisdiction to identify the applicable LCD [2]. Medical necessity must link a specific ICD-10-CM diagnosis or presenting symptom to the order. CTA chest is covered for medically necessary vascular evaluation and is not covered as a screening study in asymptomatic patients.

CY2025 Physician Fee Schedule data [3]: conversion factor = $32.3465 (reduced from $33.2875 in CY2024, per the CY2025 PFS Final Rule, 89 FR 101538, published November 29, 2024). Work RVU for 71275 is approximately 1.69 (CY2025 approximate; verify current facility and non-facility total RVUs at the CMS PFS lookup tool). BETOS = I2B (Advanced imaging, CAT/CT/CTA: other). APC status: eligible for composite APC payment. ASC: separately payable based on OPPS relative payment weights.

No specific frequency limitation for 71275 is published by CMS. Repeat studies require updated clinical documentation supporting ongoing medical necessity. For serial surveillance imaging (for example, annual thoracic aortic aneurysm follow-up for aneurysm under 5 cm), document the clinical interval basis in the ordering documentation and report.

Commercial Payers:

Prior authorization requirements for advanced CT imaging vary by payer and plan. Verify PA requirements before scheduling commercially insured patients. Some commercial payers impose diagnosis-driven prior authorization thresholds for high-cost imaging; the research document did not retrieve specific payer-level policies for 71275.

Common Denials & Prevention

Missing or insufficient CTA protocol documentation The claim is downgraded to 71260 because the record does not distinguish the CTA acquisition from a standard contrast CT. Acquisition reports using boilerplate contrast CT language are the most common trigger. Prevention: Confirm the radiology report and acquisition parameters explicitly reference bolus-tracking values, test-bolus data, or a named CTA protocol. Audit templated radiology reports to ensure CTA-specific language is not omitted on auto-populated fields.

Unbundled 3D rendering (76376 or 76377 billed with 71275) The separate postprocessing code denies because CPT parenthetical rules bundle it into 71275 [5]. This is one of the most frequently cited improper billing patterns in CT angiography audits. Prevention: Remove 76376 and 76377 from CTA chest charge capture workflows. Train charge entry staff and radiologist billing teams that postprocessing is never separately billable with 71275.

Rejected claim: invalid ICD-10-CM diagnosis code Claims submitted with I71.2 (thoracic aortic aneurysm, without rupture, parent code) reject because this code was deleted effective FY2023 [4]. Prevention: Update the charge master and coding reference tools to the granular subcodes I71.20 to I71.29. Run periodic charge master audits for deleted parent codes across all aortic aneurysm diagnoses.

MUE exceeded Billing more than one unit of 71275 on a single date of service triggers an automatic denial under the medically unlikely edit (MUE = 1) [2]. Prevention: MUE = 1 is a hard limit. Multi-region CTA acquisitions on the same date require separate codes per anatomic region (for example, 71275 for chest plus 74175 for abdomen/pelvis), not additional units of 71275.

Audit downcoding: protocol was standard contrast CT, not CTA A RAC or MAC audit identifies the acquisition as parenchymal-phase contrast CT and downcodes to 71260. This typically originates when coders select the code based on the clinical question or order language rather than the actual acquisition protocol. Prevention: Establish a coding workflow that requires review of acquisition parameters (not just the report title or order) before assigning 71275. If CTA-specific timing is not documented, report 71260.

Coding Scenarios

Scenario 1: PE workup in the emergency department

A 54-year-old presents with pleuritic chest pain, tachycardia, and an elevated D-dimer. Wells score is intermediate-high. CT pulmonary angiography is performed using CTA protocol with bolus-tracking for the pulmonary arterial phase. Acute bilateral PE is identified.

Correct coding: 71275-TC (hospital) + 71275-26 (radiologist) with ICD-10-CM I26.99

Why: The pulmonary arteries are noncoronary thoracic vessels; CTPA is the prototypical use case for 71275. The bolus-tracking protocol distinguishes this from 71260. Do not additionally report 71260 or 76377.

Scenario 2: Aortic dissection extending below the diaphragm

A 70-year-old hypertensive patient presents with tearing back pain. CTA chest and CTA abdomen/pelvis are performed in the same session to assess full dissection extent.

Correct coding: 71275 (CTA chest) + 74175-59 (CTA abdomen/pelvis, distinct acquisition) with ICD-10-CM I71.01

Why: Each anatomic CTA region requires its own code. Modifier 59 on the lower-valued code documents distinct separate acquisitions. Do not bill a single 71275 for the entire multi-region study.

Scenario 3: Surveillance aortic aneurysm ordered as "CT chest with contrast"

A 68-year-old with a known 4.3 cm thoracic aortic aneurysm undergoes annual follow-up. The order reads "CT chest with contrast for aneurysm surveillance." The technologist uses the standard 70-second portal venous phase protocol rather than a dedicated CTA timing protocol.

Correct coding: 71260 with ICD-10-CM I71.22 (thoracic aortic aneurysm, without rupture, appropriate subcode)

Why: Acquisition protocol determines the code. No bolus-tracking or CTA-specific timing was documented; reporting 71275 would constitute upcoding. If future studies use a dedicated CTA aortic protocol, 71275 would then be supported.

Scenario 4: 3D rendering generated after CTA chest

After interpreting CTA chest for PE characterization, the radiologist generates MIP images and 3D volume rendering of the pulmonary vasculature and documents the postprocessing in the interpretation report.

Correct coding: 71275-26 only

Why: CPT parenthetical instructions under 76376 and 76377 prohibit separate reporting of 3D rendering when postprocessing is included in the CT angiography code [5]. The postprocessing RVU is reflected in 71275.

Related Codes

• 71250 (CPT): CT thorax, without contrast; standard diagnostic CT, no vascular timing, mutually exclusive with 71275 on the same date
• 71260 (CPT): CT thorax, with contrast; parenchymal-phase contrast CT, most commonly confused with 71275
• 71270 (CPT): CT thorax, without and with contrast; dual-phase diagnostic CT, parenchymal timing only
• 75574 (CPT): CTA heart, coronary arteries, with 3D postprocessing; cardiac-gated coronary CTA, distinct indication from 71275
• 76376 (CPT): 3D rendering, not requiring independent workstation; bundled into 71275, never separately reportable
• 76377 (CPT): 3D rendering, requiring independent workstation; bundled into 71275, never separately reportable
• 74175 (CPT): CTA abdomen, with contrast; commonly paired with 71275 in multi-territory aortic dissection or trauma workup

Sources

1. CMS Medicare Claims Processing Manual, Chapter 13 — Radiology — Documentation requirements for radiology services
2. CMS Medicare Coverage Database — LCD search — MAC-specific LCDs governing 71275 coverage by jurisdiction; MUE tables
3. CMS CY2025 PFS Final Rule — 89 FR 101538 — CY2025 conversion factor ($32.3465) and RVU policy, published November 29, 2024
4. Local ICD-10-CM database (accessed 2026-03-18) — Confirmed deletion of I71.2 effective FY2023; active status of I26.09, I26.99; granular subcodes I71.20 to I71.29
5. Local CPT code database (accessed 2026-03-18) — MUE, PC/TC indicator, bilateral indicator, multiple procedures indicator, parenthetical guidelines, and code history for 71275, 71250, 71260, 71270, 76376, 76377, 75574
6. ACR Appropriateness Criteria — Pulmonary Embolism; Suspected Thoracic Aortic Aneurysm/Dissection — Clinical indications for CTA chest (revised 2022 to 2023)