Radiology Coding Alert

Question: How do we report for CT angiogram for pulmonary embolism with 3D reconstructions?

California Subscriber

Answer: You report the computed tomographic angiography (CTA) for pulmonary embolism with code 71275 (Computed tomographic angiography, chest [noncoronary], with contrast material[s], including noncontrast images, if performed, and image postprocessing). Code 71275 implies the use of contrast material to obtain better images.

What is CTA? CTA is performed to get detailed images of blood vessels. Cross sectional images of the area are obtained during the scanning. With the patient positioned supine, contrast material is injected at a controlled rate with the help of an automatic injection pump connected to the IV, and the table is moved through the scanner to get images which are stored and reconstructed for therapeutic analysis.

What is inclusive in CTA? CTA is inclusive of image reconstruction postprocessing and interpretation. To report angiographic reconstructions, your physician needs to use different techniques which can all broadly be classified as 3D techniques. These techniques are part of the CTA chest procedure and should not be reported separately. Therefore, you do not report code 76376 (3D rendering with interpretation and reporting of computed tomography, magnetic resonance imaging, ultrasound, or other tomographic modality with image postprocessing under concurrent supervision; not requiring image postprocessing on an independent workstation) with code 71275.

Remember! Not all CT studies with reconstruction imply a CTA. Do not report code 71275 as a reflex reaction to seeing the term ‘reconstruction’ in the clinical records. If your radiologist performed a CT study without contrast followed by reconstructions, you should report 71270 (Computed tomography, thorax; without contrast material, followed by contrast material[s] and further sections) and not 71275. Your radiologist will usually do a CTA in conditions that need an investigation of the vasculature. Examples may include pulmonary embolism or abdominal aortic aneurysm. To report a CTA, look in the clinical records for terms that support blood vessel-related diagnoses, i.e., embolism, thrombosis, aneurysm, or AV fistula.