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Question:
The patient presents with sternoclavicular (SC) joint pain, and a CT of the chest with contrast is ordered. The radiology report describes the SC joint in its entirety, but no other surrounding structures. Should I code this to 71260 or 71260-52, as only the SC joint was studied?
Answer:
CPT® does not define which specific structures must be studied to constitute a full and complete CT study. Rather, the patient’s needs/indication for the procedure defines whether a full and complete study is rendered. In this instance, 71260 is the correct code choice, as the patient presented with an indication-specific to the SC joint, and the SC joint was studied in its entirety.
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Fee schedules, relative value units, conversion factors and/or related components are not assigned by the AMA, are not part of CPT, and the AMA is not recommending their use. The AMA does not directly or indirectly practice medicine or dispense medical services. The AMA assumes no liability for data contained or not contained herein.
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