Current Procedural Terminology (CPT) codes are a standardized, five-digit language used by healthcare providers and insurers to describe medical services for billing and record-keeping purposes. These codes ensure that all parties involved are referencing the exact same service. CPT code 71275 specifically identifies a sophisticated diagnostic imaging procedure requiring specialized equipment and expertise. Understanding this code is the first step toward deciphering a medical bill for this particular test.
Definition and Scope of CPT 71275
CPT code 71275 precisely describes a “Computed tomographic angiography, chest (noncoronary), with contrast material(s), including noncontrast images, if performed, and image postprocessing.” This procedure, abbreviated as a Chest CTA, is a specialized form of computed tomography (CT) scan designed to visualize the blood vessels in the chest cavity, excluding the coronary arteries. The technique involves using a powerful X-ray machine to capture multiple cross-sectional images of the body.
To make the blood vessels clearly visible, the procedure requires the intravenous injection of a special contrast material. This contrast temporarily fills the blood vessels, making them appear bright on the resulting CT images, which is essential for detecting blockages or tears. The code also explicitly includes image postprocessing, which creates detailed 3D reconstructions of the vascular structures for the radiologist to interpret.
Clinical Reasons for the Procedure
A Chest CTA is ordered when a physician needs detailed, high-resolution information about the major blood vessels within the chest, such as the aorta and the pulmonary vasculature. The most common and urgent reason for using CPT 71275 is to diagnose a pulmonary embolism (PE), a life-threatening condition caused by blood clots blocking the arteries in the lungs. The contrast material allows the radiologist to see these clots directly.
This procedure is also the standard for evaluating diseases of the aorta, the body’s largest artery. Indications include suspected aortic dissection, where a tear occurs in the inner layer of the aortic wall, or a thoracic aortic aneurysm, an abnormal widening of the vessel that risks rupture. Furthermore, a Chest CTA is used to evaluate congenital vascular abnormalities, assess the blood supply to tumors, or for pre-surgical planning.
Understanding the Billing Components
CPT code 71275 is typically split into two distinct parts for billing: the Technical Component (TC) and the Professional Component (PC). This separation clarifies which entity is being reimbursed for which aspects of the service. The Technical Component covers the non-physician costs associated with performing the test.
This includes the cost of the CT scanner equipment, facility overhead, the wages of the radiologic technologists who perform the scan, and supplies used, such as the contrast material. The Professional Component accounts for the physician’s work. This includes the radiologist’s time for supervising the procedure, interpreting the complex images, generating the official written report, and communicating the findings back to the ordering physician.
Insurance Coverage and Patient Cost Expectations
Because a Chest CTA is a high-cost, specialized imaging procedure, insurance companies frequently require Prior Authorization (PA) before the test can be performed. PA confirms the procedure is medically necessary based on the patient’s symptoms and diagnosis. Without this pre-approval, the insurer may deny payment for the claim, leaving the patient responsible for the entire charge.
Even with insurance coverage, a patient’s out-of-pocket costs can be substantial. The patient may be responsible for meeting their annual deductible, paying a percentage of the total allowed charge through coinsurance, or contributing a fixed copayment. Patients should contact their provider and insurer beforehand to obtain an estimate of their financial liability.