Most coders check the CT Thorax coverage article when a chest CTA claim denies for medical necessity. CPT code 71275 isn’t listed there. That article’s Group 1 code list stops at 71250, 71260, and 71270, so the diagnosis your team verified against it never applied to the claim you filed. The rules for this code live somewhere else.
Key Takeaways
- CPT 71275 reports computed tomographic angiography of the chest with contrast for noncoronary vessels, covering the thoracic aorta, pulmonary arteries, and mediastinal vessels, and excluding the coronary arteries.
- Medicare pays $280.57 nationally in 2026, splitting into $83.50 for the professional component and $197.07 for the technical component.
- Coverage sits under LCD L33282 with billing article A57061, not the CT Thorax article A56580 that lists only 71250, 71260, and 71270.
- The most common denial comes from billing a chest CT and a chest CTA off one acquisition, which NCCI treats as a single reportable service.
- Noncontrast images and image postprocessing are included in the 71275 CPT code when performed in the same session, so neither one bills separately.
What CPT Code 71275 Covers
CPT code 71275 is the CPT code for CTA chest when the study targets noncoronary vessels. It requires contrast and covers the thoracic aorta, the pulmonary arteries, and the mediastinal vessels. Coronary arteries fall outside this code and carry their own family.
The Official AMA Descriptor
The full 71275 CPT code description covers computed tomographic angiography of the chest, noncoronary, with contrast material, including noncontrast images when performed, and image postprocessing. This code sits in the chest radiological procedures range, 71045 to 71555. Billing teams working from the short CMS descriptor instead of the full AMA CPT code set wording tend to miss the postprocessing language, and that gap surfaces later as a documentation problem.
What the Code Includes and What It Does Not
The CTA chest CPT code bundles more than most billing teams expect.
| Component | Included in 71275 | Billing note |
|---|---|---|
| Contrast-enhanced acquisition | Yes, required | Cannot bill for a noncontrast-only study |
| Noncontrast images | Yes, if same session | Do not bill separately |
| Image postprocessing and 3D | Yes | Bundled, must appear in the report |
| Coronary vasculature | No | Use 75574 instead |
Noncoronary is the word that decides which coverage rules apply. A chest CTA and a coronary CTA sit in different code families, and they don’t share denial patterns. Getting that boundary wrong on CPT 71275 costs your practice more than a resubmission.
Is There a CPT Code for CTA Chest With and Without Contrast?
No. There is no CPT code for CTA chest with and without contrast, because 71275 already includes noncontrast images when they are performed.
Why Coders Look for a Code That Does Not Exist
The diagnostic chest CT family splits three ways on contrast. 71250 runs without, 71260 runs with, and 71270 runs without followed by with. Coders carry that mental model into angiography and go hunting for a fourth variant. The AMA never built one. Our CT chest without contrast guide covers that three-way split in full.
The CTA descriptor solved the same problem by bundling the noncontrast phase into a single code instead of splitting it out. Searching for a cta chest with and without contrast cpt code returns results for the diagnostic family, which is where the confusion starts.
That missing code creates a predictable mistake. A coder who can’t find a cpt code for ct angio chest with and without contrast sometimes bills 71275 alongside 71270 to represent both phases. The claim then trips an NCCI edit, and both lines land in the denial queue.
If your team has been searching for a cpt code for ct angiogram chest with and without contrast, the answer is that one code already does the work of two.
When CPT 71275 Is the Right Code
Payers approve this study for a narrow set of clinical questions. Knowing which indications survive review matters more than knowing the pathology, because the diagnosis you attach decides whether CPT 71275 medical necessity holds up.
The Five Indications Payers Recognize Most Often
- Suspected acute pulmonary embolism, first-line imaging
- Thoracic aortic aneurysm, sizing and branch vessel involvement
- Aortic dissection, Stanford Type A and Type B
- Pulmonary arteriovenous malformations and congenital great vessel anomalies
- Preprocedural vascular mapping, including TAVR planning
The SCCT coverage policy covers additional vascular indications, including chest trauma protocols where the chest cta cpt code pairs with a cardiac study.
The Test That Separates 71275 From a Standard Chest CT
One question decides it: did the technologist run a dedicated angiographic acquisition targeting noncoronary thoracic vessels? Bolus timing and a vascular-phase protocol separate a CTA from a contrast-enhanced CT. A radiologist reading vascular findings off a routine chest CT hasn’t performed a CTA, and the cpt code for ct angiography chest doesn’t apply.
The error runs both directions. Some practices upcode a 71260 to 71275 because the radiologist commented on the aorta. Others undercode a real CTA to 71260 because nobody flagged the protocol at charge capture. The first invites a refund demand. The second leaves about $115 on the table per study.
CPT 71275 vs 71250, 71260, 71270, and 75574
Two variables decide every code in this family. The first is contrast status. The second is whether the technologist ran an angiographic protocol, and that second variable is the one billing teams skip.
Chest CT Code Comparison Table
| CPT code | Descriptor summary | Contrast | Angiographic protocol | Key differentiator |
|---|---|---|---|---|
| 71250 | CT thorax, without contrast | No | No | Diagnostic, no contrast |
| 71260 | CT thorax, with contrast | Yes | No | Contrast without vascular protocol |
| 71270 | CT thorax, without and with | Both | No | Two phases, still not angiographic |
| 71271 | LDCT, lung cancer screening | No | No | Screening code, driven by Z12.2 |
| 71275 | CTA chest, noncoronary | Yes, required | Yes | Dedicated vascular acquisition |
| 75574 | CCTA, coronary | Yes | Yes | Coronary vasculature only |
The acquisition separates 71260 from the 71275 CPT code. Both use contrast. Only 71275 runs a timed vascular protocol. Our lung cancer screening code guide covers the 71271 row in full, including the Z12.2 requirement that separates screening from diagnosis.
The Coronary Boundary: 71275 vs 75574
A study that reads the coronary arteries is 75574, whatever the order said. The words “CTA chest” on a requisition don’t decide the code. The acquisition and the interpretation do, and the cta of chest cpt code stops at the noncoronary vessels.
That boundary crosses into different territory on both sides. Coronary CTA carries its own prior authorization pathway and its own coverage criteria. Bill the cpt code cta chest when the radiologist read the coronaries and you’ve filed under the wrong policy, which is why the ct angiogram of chest cpt code needs checking against the report rather than the order. One exception applies in the emergency department, and the next section covers it. The same contrast-status logic drives our MRI code selection guide.
Which Medicare Coverage Document Governs CPT 71275
CPT code 71275 falls under LCD L33282 with billing article A57061, not the CT Thorax article most coders open first. That single lookup error drives more medical necessity denials on this code than any diagnosis problem.
Why the CT Thorax Article Does Not List This Code
Your coder searches chest CT coverage and lands on CMS Article A56580, the companion to LCD L33459. The Group 1 code list there contains 71250, 71260, and 71270. CPT 71275 is absent from it.
That absence matters twice over. The covered ICD-10 list attached to those three codes doesn’t govern your CTA claim, and neither does the reordering frequency limitation in the same article. Our 71250 guide documents that six-scan frequency rule in detail, and it applies to the codes A56580 lists. It doesn’t extend to 71275.
LCD L33282 and Article A57061
CMS LCD L33282 covers computed tomographic angiography of the chest, heart, and coronary arteries. Its billing companion is CMS Article A57061.
The LCD carries ICD-10 codes supporting medical necessity for this specific code, and its revision history documents additions made for 71275 on their own. That’s the list your team should verify against before a chest CTA claim goes out. Check the current version and your MAC jurisdiction in the Medicare Coverage Database, because LCDs vary by contractor and versions change.
The ED Chest Pain Rule: 71275 Only
A57061 sets a rule that catches a lot of emergency department claims. When a protocol uses cardiovascular CT angiography to work up acute chest pain, and pulmonary or aortic causes are also in question, that study codes to CPT 71275 alone.
Adding 75571, 75572, 75573, or 75574 to the same claim asserts something specific: that two entirely separate procedures were each performed in full. If one acquisition covered both questions, that assertion doesn’t hold, and the cta chest cpt code carries the claim by itself.
If your chest CTA denials keep coming back as medical necessity, check which coverage article your team verified against before you rework the diagnosis. That pattern is where our denial root-cause analysis work starts with.
CPT 71275 Reimbursement Rates for 2026
Medicare’s 2026 national rate for CPT 71275 is $280.57, split into $83.50 for the professional component and $197.07 for the technical component. Those figures come from the CMS 2026 relative value file at a conversion factor of $33.4009, effective January 1, 2026.
National Medicare Rate and Component Split
| Component | 2026 national rate | Who bills it |
|---|---|---|
| Global service | $280.57 | Provider owning the equipment |
| Professional, modifier 26 | $83.50 | Reading radiologist |
| Technical, modifier TC | $197.07 | Facility or imaging center |
| Conversion factor | $33.4009 | Applies to all components |
| Total RVUs | 8.40 | Work, practice expense, malpractice |
RVU Breakdown by Modifier
| Modifier | Work RVU | Practice expense RVU | Malpractice RVU | Total |
|---|---|---|---|---|
| Global | 1.77 | 6.49 | 0.14 | 8.400 |
| 26 | 1.77 | 0.62 | 0.11 | 2.500 |
| TC | 0.00 | 5.87 | 0.03 | 5.900 |
The work RVU sits entirely on the professional side, which is why the 71275 CPT code pays the radiologist the same 1.77 whether the claim runs global or split.
Why Your Locality Rate Is Different
Geographic practice cost indices adjust all three components, so the national figure is a pre-adjustment baseline rather than what your MAC will pay. Pull your own locality number from the CMS fee schedule lookup before you build a revenue model on it.
Two other data points answer questions that come up on audit. The status indicator is A, meaning CMS prices the code separately. The global period is XXX, so no postoperative window applies. Patients asking about their share can check the Medicare price lookup for the cpt code 71275 description and cost estimate.
How MPPR Cuts the Technical Component in Half
Under MPPR, the technical component for CPT 71275 drops from $197.07 to $98.20, a reduction of 50.2%, while the professional component falls only 5.2%. That gap decides which side of your operation absorbs the loss when a patient gets two scans in one sitting.
MPPR Rates for CPT 71275
| Component | Standard rate | MPPR rate | Reduction |
|---|---|---|---|
| Professional, modifier 26 | $83.50 | $79.16 | 5.2% |
| Technical, modifier TC | $197.07 | $98.20 | 50.2% |
| Total RVUs under MPPR | 2.500 and 5.900 | 2.370 and 2.940 | Applied to both |
A Worked Example: Chest CTA as the Second Study
A patient arrives with a suspected thoracoabdominal dissection. The technologist runs a chest CTA and an abdomen and pelvis CTA in one session, and you file 71275 and 74174. Medicare pays the higher-valued technical component in full and applies the reduction to the second one, following the imaging session rules described in CMS LCD L33459.
Run the arithmetic and the picture changes. Seven of every ten dollars on the 71275 CPT code sit on the technical side, and MPPR removes half of that when the code lands second. A facility modeling revenue on the global rate is modeling a number it will rarely collect.
The sequencing decides who absorbs it. Your reading radiologist loses about $4 on the professional side. The facility loses close to $99.
Modifier 26 and TC on CPT Code 71275
Modifier 26 reports the professional component, modifier TC reports the technical component, and a claim with no modifier reports the global service. Equipment ownership decides which one you use.
Who Bills Which Component
| Setting | What the radiologist bills | What the facility bills |
|---|---|---|
| Hospital inpatient or outpatient | 71275-26 | 71275-TC |
| Freestanding center, radiologist owns equipment | Global, no modifier | Nothing separate |
| Physician office with owned equipment | Global, no modifier | Nothing separate |
Noridian modifier 26 guidance confirms the same split logic across other imaging codes, including the ct angio chest with contrast cpt code family.
The Split That Causes the Most Denials
Billing global from a hospital setting where the technical component belongs to the facility creates a duplicate-component conflict, and the payer denies one line. The reverse error is quieter and costs more over time. Append modifier 26 when your practice owns the equipment and you’ve filed away $197.07 in technical revenue that nobody will come back for.
Look at the asymmetry. A modifier error on CPT code 71275 costs the facility roughly $197 and the radiologist roughly $83. That difference is why charge capture on the technical side deserves more attention than most practices give it, and why the cta chest with contrast cpt code shows up on so many underpayment audits.
One more modifier note. When 71275 reports alongside a procedure that triggers an NCCI edit, modifier 59 or the more specific XE, XS, XP, and XU modifiers may apply. Which pairs permit them depends on the edit indicator, and our modifier 26 and TC rules guide for MRI walks the same decision.
Modifiers That Do Not Apply to CPT 71275
Several modifier lists circulating for this code include modifiers that can’t attach to a radiology service at all. Appending one produces a rejection, not a payment, and the claim comes back before anyone reviews the clinical detail.
Modifier 91 Is Not Valid on a Radiology Code
Modifier 91 cannot be used with CPT 71275 because modifier 91 applies only to repeat clinical diagnostic laboratory tests, not to imaging services. A repeat imaging study on the same day takes modifier 76 when the same physician repeats it, or modifier 77 when a different physician does. Those two cover the repeat scenario that modifier 91 gets mistaken for.
Two others deserve a caution. Modifier 22 and modifier 52 both appear on published lists for the 71275 CPT description, and both sit awkwardly on a diagnostic imaging service with a defined acquisition protocol. A CTA either met the protocol or it didn’t. Reduced-services and increased-procedural-services arguments rarely survive review on a code like this one, so document the circumstance before you reach for either.
Can You Bill CT Chest and CTA Chest on the Same Day?
Usually no. If a single scan produced both a CT report and a CTA report, you report one code, not two.
The NCCI Rule on CT and CTA of the Same Region
NCCI Policy Manual Chapter 9, effective January 1, 2026, states that one technical study supports one reported code. You can report both a CT and a CTA of the same anatomic region only across separate patient encounters, or when the technologist ran two separate and distinct technical studies in one encounter. CMS notes that the second situation is uncommon.
Watch how the error happens. The radiologist runs one acquisition, then dictates a CT read and a CTA read off the same images. Your billing team opens two reports and files two codes. The edit fires, and both lines sit in the denial queue while somebody figures out which one to appeal.
The Medi-Cal radiology manual maps the same restriction at the state level, pairing the cta chest cpt code against 71250, 71260, and 71270 as mutually exclusive. Catching it before submission is what our clean claim standards guide covers.
NCCI PTP files also carry edit pairs for CPT code 71275 itself. Published pair lists lean heavily on anesthesia codes that rarely touch a real chest CTA claim, so check your current quarter’s file rather than trusting a static list.
Contrast Administration Is Not Separately Billable
Vascular access and contrast administration are integral to a radiology procedure using parenteral contrast, so neither one reports separately. Document the contrast in the radiology report. Don’t add an IV start or a contrast administration line to the claim because the study used contrast, and don’t let a charge master rule add it for you.
Repeat Images Do Not Create Extra Units
Repeating images during an encounter for substandard quality or additional views doesn’t generate extra units. Report one unit of the cpt code ct angio chest regardless of how many times the technologist reshot the series.
Why CPT 71275 Claims Get Denied
Denials on the 71275 CPT code cluster into six patterns, and five of them get fixed at charge capture rather than on appeal. Sorting your denials by pattern before you work them saves more revenue than working them faster.
The Six Denial Patterns and What Triggers Each
| Denial reason | Typical CARC | Root cause | Prevention |
|---|---|---|---|
| Bundling with same-session CT | CO-97 (CARC 97) | One acquisition billed as two codes | Run the NCCI check pre-submission |
| Component conflict | Duplicate denial | Global billed where facility owns technical | Fix at charge capture, not appeal |
| Medical necessity | CO-50 | Diagnosis verified against wrong article | Check L33282, not A56580 |
| Prior authorization | CO-197 | Commercial or MA requirement missed | Verify plan by plan before the scan |
| Missing contrast documentation | Varies by payer | Report omits agent, volume, or route | Standardize the report template |
| Coronary versus noncoronary | CO-50 or CO-11 | Coronary study coded as 71275 | Apply the acquisition test |
What to Do When the Denial Has Already Aged
Triage before you appeal. Component conflicts clear on a corrected resubmission most of the time. CPT 71275 medical necessity denials need documentation attached and a diagnosis pulled from the right coverage article. Aged claims need working before the timely filing window closes, because after that the aged AR recovery options narrow to nothing.
A denial category that repeats every month points at your workflow rather than your claims staff. Fix the step upstream and the same CARC stops arriving, which does more for cash flow than any appeal template will.
Recurring denial patterns don’t fix themselves at the appeal stage. If the same CARC keeps showing up on your imaging claims for the cpt code for cta chest, the fix sits upstream of the appeal, and that’s where our appeal denied imaging claims team starts.
What the Radiology Report Must Document
Four elements decide whether a CPT 71275 claim survives a records request. Miss one and the reviewer has grounds to question the code you billed.
- Name the contrast agent, the volume, and the route of administration.
- State whether the technologist acquired a noncontrast phase in the same session.
- Describe the postprocessing performed, such as MIP, MPR, or 3D reconstruction.
- Give the clinical indication, and confirm it matches the diagnosis code on the claim.
Item three carries more weight than it looks. Postprocessing sits inside the code descriptor, so a report that never mentions it gives a reviewer an opening to ask whether the study met the definition of the code you billed. That’s a downgrade exposure, not a paperwork gap, and the difference between 71275 and 71260 is about $115 per study.
One more requirement covers the whole record. Every page needs the legible signature of the practitioner responsible for the care, along with patient identification a reviewer can match to the claim.
Does CPT 71275 Include 3D Reconstruction?
Yes. CPT 71275 includes image postprocessing, because the descriptor names postprocessing as part of the service.
Reconstruction performed to generate and interpret the CTA is bundled into the code. Whether a separate advanced postprocessing code can ever report alongside 71275 depends on your current quarter’s NCCI PTP file, and those pair values change on a quarterly cycle. The SCCT MAC policy summary tracks contractor-level positions on related imaging questions.
Now the honest limit. CMS distributes the PTP files behind a click-through license, which means any pair list published in a billing guide is a snapshot that may already be stale by the time you read it. Check your own quarter before you rely on a number. That caution is part of the 71275 CPT code description in practice, even though it never appears in the descriptor itself.
Prior Authorization for Chest CTA in 2026
The answer splits by payer type, so a single verdict would mislead you. Original Medicare and commercial plans handle this code differently, and the gap has widened since 2024.
Original Medicare Does Not Require It
Original Medicare does not require prior authorization for CPT 71275, and CMS rescinded the appropriate use criteria requirement effective January 1, 2024. CMS paused the CMS AUC program and rescinded the regulation at 42 CFR 414.94, so claims no longer carry consultation information or the G-code that went with it.
Check what your claim edits still enforce. Plenty of practices run scrubbing logic that treats an AUC consultation as required for CT and CTA, and that logic went stale for 2026 dates of service. It holds clean claims for a requirement that no longer exists, and nobody notices because the hold looks like a routine edit.
Commercial Plans and Radiology Benefit Managers
Medicare Advantage and commercial plans set their own rules, and many of them delegate imaging review to a radiology benefit manager. eviCore, Carelon, and AIM review a large share of commercial imaging requests, typically with an expedited pathway when the order cites suspected pulmonary embolism or aortic dissection.
Verify plan by plan rather than building one rule for the cta chest cpt code. Requirements shift between product lines inside the same carrier, and an authorization that covered a study last quarter won’t always cover the next one.
Coding 71275 With 74174 for Thoracoabdominal Dissection
Thoracoabdominal aortic dissection requires both CPT 71275 for the chest CTA and CPT 74174 for the abdomen and pelvis CTA. Each anatomic region carries its own code, and a single line won’t cover both.
A hypertensive patient arrives with tearing back pain. Imaging runs chest and abdomen and pelvis in the same session to establish how far the dissection extends. You file both codes, adding a distinct-service modifier to the appropriate line where the payer edit calls for one.
Check the abdominal code before you file. The 74174 CPT code covers abdomen and pelvis together. 74175 covers abdomen alone, and guides circulating in this space name the wrong one often enough that it’s worth a second look at charge capture. Google’s own related searches surface the 74174 CPT code description twice and never surface 74175, which tells you which one billers reach for.
MPPR applies here, exactly as the earlier section modeled it. Two imaging studies in one session means the second technical component takes the reduction, so the cta chest abdomen pelvis cpt code combination collects meaningfully less than the sum of two global rates.
TAVR planning follows a related pattern. Preprocedural imaging sometimes splits across a cardiology read of 75574 and an interventional radiology read of 71275 and 74174, each carrying the professional modifier.
How Setting and Equipment Change What You Collect
Three separate rules reduce what a facility collects on this code, and they stack on each other. Most imaging centers model revenue against the global rate and never account for any of them.
Hospital Outpatient Versus Freestanding Imaging
Place of service decides who bills the technical component. In hospital outpatient, that side belongs to the facility and your radiologist bills the professional component alone. In a freestanding center that owns its equipment, one global claim covers both. Our POS 22 billing rules guide covers the designation that signals the split on the claim form.
The Modifier CT Reduction Most Imaging Centers Miss
CPT 71275 falls within the CMS code range 71250 through 71275 subject to the modifier CT payment reduction of 15% on the technical component when equipment does not meet NEMA Standard XR-29-2013.
CMS set that reduction at 5% for 2016 and 15% for 2017 and every year after. It applies to the technical component and to the technical portion of a global claim. The CMS CT modifier list identifies affected services, and CMS letter SC16-19 names the code ranges as 70450 through 70498 and 71250 through 71275.
Stack the reductions and the number moves a long way from $197.07. A technical component of $197.07 becomes $98.20 as a second-in-session study under MPPR, and legacy equipment takes another 15% off what remains. Model your ct angio chest cpt code revenue on the global rate and you’re modeling a figure your practice may collect on very few claims.
IDTF Supervision and Technologist Requirements
CMS lists this code under IDTF rules with radiologist physician supervision and a certified radiologic technologist holding the CT credential. A staffing mismatch turns into a denial exposure rather than an operations note. Suppliers performing advanced diagnostic imaging also need accreditation from a CMS-approved accrediting organization, and CPT code 71275 sits inside that requirement.
Most imaging practices we work with are losing more on the technical side than they realize, and it traces back to equipment status, scan sequencing, or a place-of-service mismatch nobody flagged. Our radiology billing teams start by finding which of the three is costing you.
CPT Code 71275 Frequently Asked Questions
What is CPT code 71275?
CPT code 71275 reports computed tomographic angiography of the chest for noncoronary vessels, performed with contrast. It covers the thoracic aorta, pulmonary arteries, and mediastinal vessels, and it excludes the coronary arteries.
Does CPT 71275 require contrast?
Yes. Contrast is mandatory. The descriptor defines this as a study performed with contrast material, so a chest CT run without contrast codes to 71250 instead.
Is CPT 71275 a CT scan?
Yes, a specific type. CT angiography uses a timed contrast bolus and a vascular acquisition protocol to image blood vessels, which separates it from a routine diagnostic chest CT.
Is there a CPT code for CTA chest with and without contrast?
No. That code doesn’t exist. 71275 already includes noncontrast images when the technologist acquires them in the same session, so no separate with-and-without variant was ever created.
What is the difference between 71260 and 71275?
The acquisition. Both use contrast. Only 71275 uses a timed vascular protocol targeting the thoracic vessels, and a radiologist commenting on the aorta during a routine chest CT doesn’t convert 71260 into a CTA.
What is the difference between 71275 and 75574?
Vasculature. 71275 covers noncoronary chest vessels. 75574 covers the coronary arteries. The two sit under different coverage rules and different prior authorization pathways.
Can CPT 71275 and 71260 be billed together?
Usually no. NCCI Policy Manual Chapter 9 allows one code when a single technical study generates both reports. Separate encounters or two distinct technical studies are the exceptions.
Does CPT 71275 include 3D reconstruction?
Yes. Image postprocessing is named in the descriptor and bundled into the code. Document the reconstruction in the report, because a missing mention invites a downgrade question.
What modifier is used with CPT 71275?
Equipment ownership decides it. Hospitals bill 71275-TC while the radiologist bills 71275-26. A practice that owns its own scanner bills globally with no modifier at all.
What does Medicare pay for CPT 71275 in 2026?
$280.57 nationally for the global service, splitting into $83.50 professional and $197.07 technical, at a conversion factor of $33.4009. Your locality rate will differ after geographic adjustment.
Does CPT 71275 require prior authorization?
Not under Original Medicare, and no AUC consultation either since CMS rescinded that rule in January 2024. Medicare Advantage and commercial plans set their own requirements, so verify each one.
Is CPT 71275 still valid in 2026?
Yes. Status indicator A, descriptor unchanged, no deletion or revision. The 2026 radiology additions were 70471, 70472, and 70473 for head and neck CTA and cerebral perfusion, and none of them touched this code.
What This Guide Verified and What It Could Not
Every rate, code range, and coverage rule above traces to a named CMS or AMA document with an effective date attached. Two things fall outside that standard, and you should know which ones before you build a workflow on this page.
No medically unlikely edit value appears here for CPT code 71275. CMS maintains MUEs, not every code carries one, some published values stay confidential, and the tables refresh quarterly. Pull yours from the current CMS table rather than from any guide.
No fixed NCCI PTP pair list appears here either, for the reason given earlier. Those files move quarterly and sit behind a click-through license.
One caveat on the coverage documents. LCDs vary by Medicare Administrative Contractor, so confirm the current version and jurisdiction for L33282 and A57061 in the Medicare Coverage Database before you rely on either for a specific claim.
