{"id":4891,"date":"2025-09-19T16:44:54","date_gmt":"2025-09-19T16:44:54","guid":{"rendered":"https:\/\/medibillmd.com\/blog\/?p=4891"},"modified":"2025-09-19T16:44:56","modified_gmt":"2025-09-19T16:44:56","slug":"cpt-code-71260","status":"publish","type":"post","link":"https:\/\/medibillmd.com\/blog\/cpt-code-71260\/","title":{"rendered":"Ultimate Guide to CPT Code 71260"},"content":{"rendered":"\n<p>Want to bill a chest CT scan, but not sure which code to use? You are not alone. Many billers face the same situation. Thoracic computed tomography is mainly billed with three CPT codes. Each code represents a slight variation of the procedure and often confuses the billers.<\/p>\n\n\n\n<p>One of these codes is CPT code 71260. In this guide, we have tried our best to clear your concepts regarding thorax CT scans. We will provide a detailed explanation of the code, the difference between the three codes, applicable modifiers, and some important billing guidelines.&nbsp;<\/p>\n\n\n\n<p>So, let\u2019s start.&nbsp;<\/p>\n\n\n\t\t\t\t<div class=\"wp-block-uagb-table-of-contents uagb-toc__align-left uagb-toc__columns-1 uagb-toc__collapse uagb-block-ad320ffa      \"\n\t\t\t\t\tdata-scroll= \"1\"\n\t\t\t\t\tdata-offset= \"30\"\n\t\t\t\t\tstyle=\"\"\n\t\t\t\t>\n\t\t\t\t<div class=\"uagb-toc__wrap\">\n\t\t\t\t\t\t<div class=\"uagb-toc__title\">\n\t\t\t\t\t\t\tTable Of Contents\t\t\t\t\t\t\t\t\t\t\t\t\t<svg xmlns=\"https:\/\/www.w3.org\/2000\/svg\" viewBox= \"0 0 384 512\"><path d=\"M192 384c-8.188 0-16.38-3.125-22.62-9.375l-160-160c-12.5-12.5-12.5-32.75 0-45.25s32.75-12.5 45.25 0L192 306.8l137.4-137.4c12.5-12.5 32.75-12.5 45.25 0s12.5 32.75 0 45.25l-160 160C208.4 380.9 200.2 384 192 384z\"><\/path><\/svg>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<div class=\"uagb-toc__list-wrap \">\n\t\t\t\t\t\t<ol class=\"uagb-toc__list\"><li class=\"uagb-toc__list\"><a href=\"#cpt-code-71260-description\" class=\"uagb-toc-link__trigger\">CPT Code 71260 \u2013 Description<\/a><li class=\"uagb-toc__list\"><a href=\"#scenarios-where-cpt-code-71260-is-applicable\" class=\"uagb-toc-link__trigger\">Scenarios Where CPT Code 71260 is Applicable<\/a><ul class=\"uagb-toc__list\"><li class=\"uagb-toc__list\"><a href=\"#amebic-lung-abscess\" class=\"uagb-toc-link__trigger\">Amebic Lung Abscess<\/a><li class=\"uagb-toc__list\"><li class=\"uagb-toc__list\"><a href=\"#pulmonary-anthrax\" class=\"uagb-toc-link__trigger\">Pulmonary Anthrax<\/a><\/li><\/ul><\/li><li class=\"uagb-toc__list\"><a href=\"#applicable-modifiers-for-cpt-code-71260\" class=\"uagb-toc-link__trigger\">Applicable Modifiers for CPT Code 71260<\/a><li class=\"uagb-toc__list\"><a href=\"#cpt-code-71260-billing-reimbursement-guidelines\" class=\"uagb-toc-link__trigger\">CPT Code 71260 \u2013 Billing &amp; Reimbursement Guidelines<\/a><ul class=\"uagb-toc__list\"><li class=\"uagb-toc__list\"><a href=\"#provide-detailed-documentation\" class=\"uagb-toc-link__trigger\">Provide Detailed Documentation<\/a><li class=\"uagb-toc__list\"><li class=\"uagb-toc__list\"><a href=\"#check-the-reimbursement-amount\" class=\"uagb-toc-link__trigger\">Check the Reimbursement Amount<\/a><li class=\"uagb-toc__list\"><li class=\"uagb-toc__list\"><a href=\"#justify-with-valid-icd-10-codes\" class=\"uagb-toc-link__trigger\">Justify with Valid ICD-10 Codes<\/a><\/li><\/ul><\/li><\/ul><\/li><li class=\"uagb-toc__list\"><a href=\"#wrapping-up\" class=\"uagb-toc-link__trigger\">Wrapping Up\u00a0<\/a><\/ul><\/ul><\/ol>\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\n\n\n<div style=\"height:30px\" aria-hidden=\"true\" class=\"wp-block-spacer\"><\/div>\n\n\n\n<h2 class=\"wp-block-heading\"><strong>CPT Code 71260<\/strong><strong> \u2013 Description<\/strong><\/h2>\n\n\n\n<p>CPT code 71260 is officially defined as:<\/p>\n\n\n\n<blockquote class=\"wp-block-quote has-ast-global-color-4-background-color has-background is-layout-flow wp-block-quote-is-layout-flow\">\n<p><strong><em>&#8220;Computed tomography, thorax; with contrast material.&#8221;<\/em><\/strong><\/p>\n<\/blockquote>\n\n\n\n<p>To better understand the billing procedure and requirements, let\u2019s first break this down in more detail.&nbsp;<\/p>\n\n\n\n<p>Code 71260 is used in radiology billing to bill a computed tomography (CT scan) of the chest area to create a detailed cross-sectional image. The important point to note here is that, unlike simple CT scans, 71260 involves the use of contrast material to provide better visualization of blood vessels, soft tissues, and other anatomical structures.<\/p>\n\n\n\n<p>Normally, the radiologists use iodine-based contrast for the procedure. The contrast dye is injected into the patient intravenously before the scan. The description seems simple enough. However, many billers get confused during the code selection. So, we must clarify the difference between the codes.&nbsp;<\/p>\n\n\n\n<p>The following are the CPT codes for chest-related CT scans:<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li><strong><a href=\"https:\/\/medibillmd.com\/blog\/cpt-code-71250\/\" target=\"_blank\" rel=\"noreferrer noopener\">CPT code 71250<\/a>:<\/strong> Thorax CT scan without contrast material<\/li>\n\n\n\n<li><strong>CPT code 71260<\/strong><strong>:<\/strong> Thorax CT scan with contrast material<\/li>\n\n\n\n<li><strong>CPT code 71270:<\/strong> Thorax CT scan without contrast, followed by scans with contrast material<\/li>\n<\/ul>\n\n\n\n<h2 class=\"wp-block-heading\"><strong>Scenarios Where <\/strong><strong>CPT Code 71260<\/strong><strong> is Applicable<\/strong><\/h2>\n\n\n\n<p>To make things clear, let\u2019s look at a couple of real-world scenarios in which CPT code 71260 can be used.<\/p>\n\n\n\n<h3 class=\"wp-block-heading\"><strong>Amebic Lung Abscess<\/strong><\/h3>\n\n\n\n<p>Suppose a 45-year-old man comes to the emergency room. He has had a persistent fever, productive cough with bloody sputum, and severe chest pain for the past week. Upon inquiry, the patient reveals that he recently returned from a tropical region where he experienced gastrointestinal symptoms.&nbsp;<\/p>\n\n\n\n<p>Initial chest X-rays show suspicious pulmonary lesions. However, X-ray imaging is unable to detect the actual problem and nature of the lesions. Standard antibiotic treatments for bacterial pneumonia show no improvement in the patient&#8217;s deteriorating condition.<\/p>\n\n\n\n<p>Considering the recent travel and symptoms, the physician suspects a parasitic lung infection, specifically an amebic lung abscess. To confirm the diagnosis, he orders a contrast-enhanced CT scan of the chest. The billing department can use CPT code 71260 in this case to bill the CT scan.&nbsp;<\/p>\n\n\n\n<h3 class=\"wp-block-heading\"><strong>Pulmonary Anthrax<\/strong><\/h3>\n\n\n\n<p>Let\u2019s consider another scenario. Suppose a man who works in the wool processing industry comes to the ER. He complains of severe breathing distress that was initiated suddenly. The man also has a high fever and a non-productive cough. For a quick checkup, the physician in the ER performs a chest X-ray. The X-ray comes out concerning and shows bilateral pleural effusions. Plus, the patient is not responding to mild medications, and his condition is deteriorating quickly.<\/p>\n\n\n\n<p>This raises suspicion of a more severe underlying condition. So, the physician orders a detailed chest CT scan with contrast. The scan provides high-quality images of the thorax, and the physician confirms a case of pulmonary anthrax. The CT scan in this case can be billed with CPT code 71260.&nbsp;<\/p>\n\n\n\n<h2 class=\"wp-block-heading\"><strong>Applicable Modifiers for <\/strong><strong>CPT Code 71260<\/strong><\/h2>\n\n\n\n<p>You can append the following modifiers to CPT code 71260:<\/p>\n\n\n\n<figure class=\"wp-block-table is-style-stripes\"><table><thead><tr><th class=\"has-text-align-center\" data-align=\"center\"><strong>Modifier<\/strong><\/th><th class=\"has-text-align-center\" data-align=\"center\"><strong>Description<\/strong><\/th><th class=\"has-text-align-center\" data-align=\"center\"><strong>Application<\/strong><\/th><\/tr><\/thead><tbody><tr><td class=\"has-text-align-center\" data-align=\"center\"><a href=\"https:\/\/medibillmd.com\/blog\/modifier-tc\/\" target=\"_blank\" rel=\"noreferrer noopener\">TC<\/a><\/td><td class=\"has-text-align-center\" data-align=\"center\">Technical Component<\/td><td class=\"has-text-align-center\" data-align=\"center\">Used when billing only for the technical aspects of the procedure (equipment, technician, supplies).<\/td><\/tr><tr><td class=\"has-text-align-center\" data-align=\"center\"><a href=\"https:\/\/medibillmd.com\/blog\/modifier-26\/\" target=\"_blank\" rel=\"noreferrer noopener\">26<\/a><\/td><td class=\"has-text-align-center\" data-align=\"center\">Professional Component<\/td><td class=\"has-text-align-center\" data-align=\"center\">Used when the physician interprets the results but does not own the equipment.<\/td><\/tr><tr><td class=\"has-text-align-center\" data-align=\"center\"><a href=\"https:\/\/medibillmd.com\/blog\/modifier-52\/\" target=\"_blank\" rel=\"noreferrer noopener\">52<\/a><\/td><td class=\"has-text-align-center\" data-align=\"center\">Reduced Services<\/td><td class=\"has-text-align-center\" data-align=\"center\">Used when the service is partially reduced or eliminated.<\/td><\/tr><tr><td class=\"has-text-align-center\" data-align=\"center\"><a href=\"https:\/\/medibillmd.com\/blog\/modifier-51-vs-59\/\" target=\"_blank\" rel=\"noreferrer noopener\">59<\/a><\/td><td class=\"has-text-align-center\" data-align=\"center\">Distinct Procedural Service<\/td><td class=\"has-text-align-center\" data-align=\"center\">Indicates CT scan is separate and distinct from other procedures performed on the same day.<\/td><\/tr><tr><td class=\"has-text-align-center\" data-align=\"center\"><a href=\"https:\/\/medibillmd.com\/blog\/modifier-76\/\" target=\"_blank\" rel=\"noreferrer noopener\">76<\/a><\/td><td class=\"has-text-align-center\" data-align=\"center\">Repeat Procedure, Same Provider<\/td><td class=\"has-text-align-center\" data-align=\"center\">Used when the same provider repeats the procedure on the same day.<\/td><\/tr><tr><td class=\"has-text-align-center\" data-align=\"center\"><a href=\"https:\/\/medibillmd.com\/blog\/modifier-77\/\" target=\"_blank\" rel=\"noreferrer noopener\">77<\/a><\/td><td class=\"has-text-align-center\" data-align=\"center\">Repeat Procedure, Another Provider<\/td><td class=\"has-text-align-center\" data-align=\"center\">Used when a different provider repeats the procedure on the same day.<\/td><\/tr><\/tbody><\/table><\/figure>\n\n\n\n<h2 class=\"wp-block-heading\"><strong>CPT Code 71260<\/strong><strong> \u2013 Billing &amp; Reimbursement Guidelines<\/strong><\/h2>\n\n\n\n<p>Applying the correct code, but still getting hit with denials? The problem may be the minor details that you are missing. Here is what you should keep in mind when billing for CPT code 71260:<\/p>\n\n\n\n<h3 class=\"wp-block-heading\"><strong>Provide Detailed Documentation<\/strong><\/h3>\n\n\n\n<p>For 71260, you must append the following details to your claims. :<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li>Patient\u2019s name<\/li>\n\n\n\n<li>Date of service<\/li>\n\n\n\n<li>Written request from the physician who ordered the CT scan<\/li>\n\n\n\n<li>Notes explaining why the patient needs the scan<\/li>\n\n\n\n<li>Official results written by the radiologist<\/li>\n\n\n\n<li>Proper signatures from qualified medical staff<\/li>\n\n\n\n<li>List of symptoms<\/li>\n\n\n\n<li>Patient&#8217;s health history and any previous test results<\/li>\n<\/ul>\n\n\n\n<h3 class=\"wp-block-heading\"><strong>Check the Reimbursement Amount<\/strong><\/h3>\n\n\n\n<p>The reimbursement amount for CPT code 71260 varies for each MAC locality. The national average reimbursement amount for 71260 is $164.32 in non-facility settings.&nbsp;<\/p>\n\n\n\n<p>The following is a more detailed breakdown of the cost structure:<\/p>\n\n\n\n<ol class=\"wp-block-list\">\n<li><strong>Professional component:<\/strong><\/li>\n<\/ol>\n\n\n\n<ol class=\"wp-block-list\">\n<li><strong>Facility price:<\/strong> $53.05<\/li>\n\n\n\n<li><strong>Non-facility price: <\/strong>$53.05<\/li>\n<\/ol>\n\n\n\n<ol start=\"2\" class=\"wp-block-list\">\n<li><strong>Technical component:<\/strong><\/li>\n<\/ol>\n\n\n\n<ol class=\"wp-block-list\">\n<li><strong>Non-facility price:<\/strong> $111.27<\/li>\n<\/ol>\n\n\n\n<p>You can check the exact reimbursement rate for your MAC locality via the <a href=\"https:\/\/www.cms.gov\/medicare\/physician-fee-schedule\/search?Y=0&amp;T=4&amp;HT=0&amp;CT=3&amp;H1=71260&amp;M=5\" target=\"_blank\" rel=\"noreferrer noopener nofollow\">PFS Lookup Tool<\/a>.\u00a0<\/p>\n\n\n\n<h3 class=\"wp-block-heading\"><strong>Justify with Valid ICD-10 Codes<\/strong><\/h3>\n\n\n\n<p>Attaching the right documentation is not enough. Your claims must include valid and relevant ICD-10 codes to support the medical necessity of the CT scan.&nbsp;&nbsp;<\/p>\n\n\n\n<p>Common diagnosis codes used with CPT code 71260 include:<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li><strong>A15.9:<\/strong> Respiratory tuberculosis unspecified<\/li>\n\n\n\n<li><strong>A18.01:<\/strong> Tuberculosis of the spine<\/li>\n\n\n\n<li><strong>A18.84:<\/strong> Tuberculosis of the heart<\/li>\n\n\n\n<li><strong>A19.9:<\/strong> Miliary tuberculosis, unspecified<\/li>\n\n\n\n<li><strong>A22.1: <\/strong>Pulmonary anthrax<\/li>\n\n\n\n<li><strong>A31.0: <\/strong>Pulmonary mycobacterial infection<\/li>\n<\/ul>\n\n\n\n<p>To get the complete list of ICD-10 codes that justify medical necessity for code 71260, you can check the official <a href=\"https:\/\/www.cms.gov\/medicare-coverage-database\/view\/article.aspx?articleid=56580&amp;ver=28&amp;\" target=\"_blank\" rel=\"noreferrer noopener nofollow\">CMS guide<\/a> on Computerized Axial Tomography (CT), Thorax.<\/p>\n\n\n\n<h2 class=\"wp-block-heading\"><strong>Wrapping Up<\/strong>&nbsp;<\/h2>\n\n\n\n<p>In this blog, we tried our best to simplify CPT code 71260 for you. By implementing the best practices outlined in this guide, you can avoid claim denials and get fair reimbursement for your services.<\/p>\n\n\n\n<p>However, if you are facing continuous denials or do not have a specialized radiology billing team, you can always seek professional help. Many billing companies like MediBillMD offer affordable<strong> <\/strong><a href=\"https:\/\/medibillmd.com\/specialties\/radiology-billing-services\" target=\"_blank\" rel=\"noreferrer noopener nofollow\"><strong>radiology billing services<\/strong><\/a> to help reduce your administrative workload.<\/p>\n","protected":false},"excerpt":{"rendered":"<p>Want to bill a chest CT scan, but not sure which code to use? You are not alone. Many billers [&hellip;]<\/p>\n","protected":false},"author":3,"featured_media":4892,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"_eb_attr":"","content-type":"","_uag_custom_page_level_css":"","site-sidebar-layout":"default","site-content-layout":"","ast-site-content-layout":"default","site-content-style":"default","site-sidebar-style":"default","ast-global-header-display":"","ast-banner-title-visibility":"","ast-main-header-display":"","ast-hfb-above-header-display":"","ast-hfb-below-header-display":"","ast-hfb-mobile-header-display":"","site-post-title":"","ast-breadcrumbs-content":"","ast-featured-img":"","footer-sml-layout":"","ast-disable-related-posts":"","theme-transparent-header-meta":"","adv-header-id-meta":"","stick-header-meta":"","header-above-stick-meta":"","header-main-stick-meta":"","header-below-stick-meta":"","astra-migrate-meta-layouts":"default","ast-page-background-enabled":"default","ast-page-background-meta":{"desktop":{"background-color":"var(--ast-global-color-4)","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""},"tablet":{"background-color":"","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""},"mobile":{"background-color":"","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""}},"ast-content-background-meta":{"desktop":{"background-color":"var(--ast-global-color-5)","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""},"tablet":{"background-color":"var(--ast-global-color-5)","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""},"mobile":{"background-color":"var(--ast-global-color-5)","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""}},"footnotes":""},"categories":[10],"tags":[],"class_list":["post-4891","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-cpt-codes"],"uagb_featured_image_src":{"full":["https:\/\/medibillmd.com\/blog\/wp-content\/uploads\/2025\/09\/CPT-Code-71260.webp",1200,720,false],"thumbnail":["https:\/\/medibillmd.com\/blog\/wp-content\/uploads\/2025\/09\/CPT-Code-71260-150x150.webp",150,150,true],"medium":["https:\/\/medibillmd.com\/blog\/wp-content\/uploads\/2025\/09\/CPT-Code-71260-300x180.webp",300,180,true],"medium_large":["https:\/\/medibillmd.com\/blog\/wp-content\/uploads\/2025\/09\/CPT-Code-71260-768x461.webp",768,461,true],"large":["https:\/\/medibillmd.com\/blog\/wp-content\/uploads\/2025\/09\/CPT-Code-71260-1024x614.webp",1024,614,true],"1536x1536":["https:\/\/medibillmd.com\/blog\/wp-content\/uploads\/2025\/09\/CPT-Code-71260.webp",1200,720,false],"2048x2048":["https:\/\/medibillmd.com\/blog\/wp-content\/uploads\/2025\/09\/CPT-Code-71260.webp",1200,720,false]},"uagb_author_info":{"display_name":"Fred Allen","author_link":"https:\/\/medibillmd.com\/blog\/author\/fred-allen\/"},"uagb_comment_info":0,"uagb_excerpt":"Want to bill a chest CT scan, but not sure which code to use? You are not alone. Many billers [&hellip;]","_links":{"self":[{"href":"https:\/\/medibillmd.com\/blog\/wp-json\/wp\/v2\/posts\/4891","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/medibillmd.com\/blog\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/medibillmd.com\/blog\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/medibillmd.com\/blog\/wp-json\/wp\/v2\/users\/3"}],"replies":[{"embeddable":true,"href":"https:\/\/medibillmd.com\/blog\/wp-json\/wp\/v2\/comments?post=4891"}],"version-history":[{"count":0,"href":"https:\/\/medibillmd.com\/blog\/wp-json\/wp\/v2\/posts\/4891\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/medibillmd.com\/blog\/wp-json\/wp\/v2\/media\/4892"}],"wp:attachment":[{"href":"https:\/\/medibillmd.com\/blog\/wp-json\/wp\/v2\/media?parent=4891"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/medibillmd.com\/blog\/wp-json\/wp\/v2\/categories?post=4891"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/medibillmd.com\/blog\/wp-json\/wp\/v2\/tags?post=4891"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}