Current Procedural Terminology (CPT) codes are standardized five-digit identifiers used by healthcare providers to describe medical, surgical, and diagnostic services for billing and reporting. CPT code 71271 specifically identifies a highly targeted preventive service: “Computed tomography, thorax, low dose for lung cancer screening, without contrast material(s).” This unique designation signals to payers that the procedure is a proactive screening measure for high-risk individuals, rather than a diagnostic tool for a known illness.
The Low-Dose Lung Screening Procedure
The procedure represented by CPT 71271 is a specialized imaging test known as Low-Dose Computed Tomography (LDCT) of the chest. A standard CT scan uses X-rays and computer processing to generate detailed cross-sectional images of the body, but the LDCT technique significantly minimizes the radiation exposure. This reduction in radiation is achieved through optimized scanner protocols, such as lower tube current (measured in milliampere-seconds or mAs) and sometimes a lower voltage (kVp), which is acceptable because the primary goal is to visualize large lung nodules.
The technical compromise of using less radiation still produces images clear enough to identify suspicious growths in the lungs without the high radiation burden of a full diagnostic chest CT. Since the scan is purely for screening, it focuses mainly on the lung parenchyma, which is the functional tissue of the lungs. The patient experience is typically quick, involving lying still on a table that slides through the CT scanner while holding their breath for a few seconds.
The entire scan process generally takes less than a minute, which helps to reduce motion artifacts and makes it easily repeatable for annual screening. Unlike many other CT procedures, the LDCT for lung screening must be performed without the use of intravenous (IV) contrast material. Contrast agents, which highlight blood vessels and soft tissues, are generally not necessary to detect the solid or semi-solid nodules that are the focus of lung cancer screening.
This specific technical approach ensures the benefit of early cancer detection outweighs the small, cumulative risk of radiation exposure from repeated annual scans. The resulting images are then analyzed by a radiologist, who looks for small abnormalities that may indicate early-stage lung cancer.
Clinical Indications for Screening
The medical justification for performing the procedure coded as 71271 rests entirely on identifying a specific high-risk population before they develop any symptoms. Lung cancer screening is not recommended for the general population because the benefits do not outweigh the potential harms, such as false positives and unnecessary follow-up procedures. It is designed to find early-stage cancer in asymptomatic people who face a substantially elevated risk due to their smoking history.
Guidelines from organizations like the United States Preventive Services Task Force (USPSTF) establish the criteria for patient eligibility. The recommendation applies to adults between the ages of 50 and 80 who have a significant smoking history, quantified as a 20 pack-year history. This means smoking the equivalent of one pack per day for 20 years.
Furthermore, the patient must either be a current smoker or have quit smoking within the last 15 years to remain eligible for the annual screening. Once a person has abstained from smoking for more than 15 years, their risk level drops, and the annual screening is typically discontinued. The patient must also be free of any signs or symptoms suggestive of lung cancer, such as unexplained cough, chest pain, or weight loss, as the procedure is a screening tool, not a diagnostic one.
A detailed discussion with the patient, known as a shared decision-making visit, is a precursor to the first LDCT scan. This conversation ensures the patient understands the benefits of early detection, the potential for false-positive results, and the importance of adhering to the annual screening schedule. The primary objective is to reduce lung cancer mortality by catching cancerous nodules when they are small and localized, making treatment significantly more effective.
Administrative Requirements for Billing
CPT 71271 is distinct from other chest CT codes, such as CPT 71250, because it is strictly reserved for a preventive service. This code informs the insurer that the procedure was a lung cancer screening for an asymptomatic, high-risk patient. If a patient is exhibiting symptoms, a diagnostic CT code must be used instead, even if the same equipment is utilized.
The descriptor for CPT 71271 includes two non-negotiable technical constraints that must be met for the code to be valid. The first is that the procedure must be “low dose,” requiring the imaging facility to use specific, low-radiation protocols established for screening. The second constraint is that the procedure must be performed “without contrast material(s),” meaning no IV contrast agent was administered to the patient.
Accurate documentation is necessary to justify the use of this specific screening code. The patient’s medical record must clearly indicate that they meet the accepted eligibility criteria related to age and smoking history, often using specific diagnosis codes to indicate their high-risk status. Additionally, the required physician order must explicitly state that the scan is for lung cancer screening.
This documentation helps demonstrate the medical justification for the service and confirms the patient’s asymptomatic status, which is a key differentiator from diagnostic imaging. Facilities must also document that the necessary shared decision-making visit occurred before the initial screening. The administrative specificity of CPT 71271 ensures the service aligns precisely with the clinical evidence and regulatory standards established for lung cancer prevention programs.