71250
CT chest, without contrast
Computed tomography of the thorax (chest) without contrast material. CMS 2026 global wRVU 1.08, total RVU approximately 3.57, Medicare global allowable approximately $119. Used for pulmonary nodule characterization, low-dose lung screening (when paired with appropriate G-codes), and chest pathology not requiring vascular contrast detail.
When to use it
Use 71250 when chest CT without contrast is the indicated study: pulmonary nodule follow-up per Fleischner Society guidelines, interstitial lung disease evaluation, COPD/emphysema characterization, pre-operative thoracic surgery planning, suspected pulmonary fibrosis. 71260 (with contrast) is used for hilar mass, mediastinal lymphadenopathy, post-treatment oncology surveillance.
Full guidance
71270 (without and with) is reserved for complex cases requiring both characterizations. 71275 (CTA chest) is the PE-protocol study with timed contrast bolus and is a different code. For Medicare low-dose CT lung cancer screening, use G0297 (the screening-specific HCPCS code) instead of 71250.
Documentation checklist
- ✓Order with indication (pulmonary nodule follow-up, ILD evaluation, COPD characterization, etc.).
- ✓Interpretation report addressing lung fields, airways, mediastinum, hilum, pleura, chest wall, bones, upper abdomen visible on the field. Comparison to prior imaging where available.
- ✓Nodule measurements with Fleischner classification if pulmonary nodules are present.
- ✓Lung-RADS category if performed as screening (low-dose protocol with G0297).
- ✓Setting modifier and signature.
Common pitfalls
- !Billing 71250 for what was actually a CT pulmonary angiogram (PE-protocol). The PE-protocol CT is 71275, not 71250 + IV contrast administration codes.
- !Billing 71250 for low-dose CT lung cancer screening on a Medicare patient. Medicare requires G0297 for screening, not 71250. Commercial payers vary.
- !Reading a high-quality chest CT and billing 71250 alongside abdomen CT when the abdomen was incidentally included. Use a combined chest-abdomen-pelvis code only when explicitly ordered and acquired.
- !Confusing 71250 with 71260 when contrast was given for a different indication. The without-contrast and with-contrast codes are different studies.
- !Missing the comparison-to-prior in the report. Many payers audit chest CT reports for serial-comparison documentation, especially for nodule surveillance.
Payer notes
Medicare covers 71250 with appropriate indication. Lung cancer screening is a separate benefit under G0297 with strict eligibility (age 50 to 77, 20 pack-year history, current smoker or quit within 15 years, asymptomatic). Commercial payers vary on prior auth requirements; most reserve auth for outpatient chest CT without urgent indication. Some Medicare Advantage plans deny 71250 if an outpatient indication doesn't reach a documented threshold of suspicion.