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Official Description

Cerebral perfusion analysis using computed tomography with contrast administration, including post-processing of parametric maps with determination of cerebral blood flow, cerebral blood volume, and mean transit time

© Copyright 2025 American Medical Association. All rights reserved.

Common Language Description

Cerebral perfusion analysis is a diagnostic procedure that involves the administration of a contrast agent into a blood vessel to evaluate the blood flow within the cerebral microvascular system. This process is facilitated by computed tomography (CT), a sophisticated imaging technique that provides detailed cross-sectional images of the brain. The primary goal of this analysis is to assess various parameters related to cerebral perfusion, which is crucial for understanding the brain's blood supply and identifying potential abnormalities. The procedure, identified by CPT® Code 0042T, encompasses not only the initial imaging but also the post-processing of parametric maps. These maps are essential for determining key metrics such as cerebral blood flow (CBF), cerebral blood volume (CBV), and mean transit time (MTT). Each of these parameters offers valuable insights into the brain's vascular health and can aid in diagnosing conditions such as stroke, tumors, or other cerebrovascular disorders.

© Copyright 2025 Coding Ahead. All rights reserved.

1. Indications

The cerebral perfusion analysis using computed tomography with contrast administration is indicated for various clinical scenarios where assessment of cerebral blood flow and vascular integrity is necessary. The following conditions may warrant this procedure:

  • Stroke Evaluation This procedure is often performed to assess patients suspected of having an acute stroke, as it helps in determining the extent of ischemia and the viability of brain tissue.
  • Brain Tumors Cerebral perfusion analysis can assist in evaluating brain tumors by providing information on blood supply to the tumor, which is critical for treatment planning and monitoring.
  • Cerebrovascular Disorders Conditions such as arteriovenous malformations (AVMs) or other vascular anomalies may require this analysis to understand blood flow dynamics and potential risks.
  • Traumatic Brain Injury In cases of head trauma, this procedure can help assess the perfusion status of the brain, guiding management decisions.

2. Procedure

The procedure for cerebral perfusion analysis using computed tomography with contrast administration involves several key steps that ensure accurate measurement of cerebral blood flow and related parameters. The following outlines the procedural steps:

  • Step 1: Patient Preparation Prior to the procedure, the patient is prepared by ensuring that they have fasted as required and that any necessary pre-procedural assessments, such as renal function tests, have been completed. The patient is informed about the procedure, including the use of contrast material, and consent is obtained.
  • Step 2: Contrast Administration The procedure begins with the intravenous administration of a contrast agent. This contrast material is crucial for enhancing the visibility of blood vessels and perfusion during the CT imaging process.
  • Step 3: Imaging Acquisition Following the contrast injection, a series of CT scans are performed. These scans capture images of the brain at specific intervals to track the flow of the contrast agent through the cerebral vasculature, allowing for the assessment of blood flow dynamics.
  • Step 4: Post-Processing of Images After the imaging acquisition, the obtained CT images undergo post-processing to create parametric maps. These maps are generated using specialized software that analyzes the imaging data to quantify cerebral blood flow, cerebral blood volume, and mean transit time.
  • Step 5: Interpretation of Results The final step involves the interpretation of the parametric maps by a qualified radiologist or physician. The results are analyzed to identify any abnormalities in cerebral perfusion, which can inform clinical decision-making and patient management.

3. Post-Procedure

After the cerebral perfusion analysis is completed, patients are typically monitored for a short period to ensure there are no immediate adverse reactions to the contrast material. Depending on the patient's condition and the facility's protocols, they may be discharged shortly after the procedure. It is important for patients to be informed about potential side effects of the contrast agent, such as allergic reactions or nephrotoxicity, especially in those with pre-existing kidney issues. Follow-up appointments may be scheduled to discuss the results of the analysis and any further diagnostic or therapeutic steps that may be necessary based on the findings.

Short Descr CT PERFUSION W/CONTRAST CBF
Medium Descr CEREBRAL PERFUSION ANALYS CT W/BLOOD FLOW&VOLUME
Long Descr Cerebral perfusion analysis using computed tomography with contrast administration, including post-processing of parametric maps with determination of cerebral blood flow, cerebral blood volume, and mean transit time
Status Code Carriers Price the Code
Global Days XXX - Global Concept Does Not Apply
PC/TC Indicator (26, TC) 0 - Physician Service Code
Multiple Procedures (51) 0 - No payment adjustment rules for multiple procedures apply.
Bilateral Surgery (50) 0 - 150% payment adjustment for bilateral procedures does NOT apply.
Physician Supervisions 09 - Concept does not apply.
Assistant Surgeon (80, 82) 0 - Payment restriction for assistants at surgery applies to this procedure...
Co-Surgeons (62) 0 - Co-surgeons not permitted for this procedure.
Team Surgery (66) 0 - Team surgeons not permitted for this procedure.
Diagnostic Imaging Family 99 - Concept Does Not Apply
APC Status Indicator Items and Services Packaged into APC Rates
Type of Service (TOS) 4 - Diagnostic Radiology
Berenson-Eggers TOS (BETOS) I2B - Advanced imaging - CAT/CT/CTA: other
MUE 1
CCS Clinical Classification 180 - Other CT scan
X5 Diagnostic services requested by another clinician: for reporting services by a clinician who furnishes care to the patient only as requested by another clinician or subsequent and related services requested by another clinician; this modifier is reported for patient relationships that may not be adequately captured by the above alternative categories; reporting clinician service examples include but are not limited to, the radiologist's interpretation of an imaging study requested by another clinician
GZ Item or service expected to be denied as not reasonable and necessary
GC This service has been performed in part by a resident under the direction of a teaching physician
MA Ordering professional is not required to consult a clinical decision support mechanism due to service being rendered to a patient with a suspected or confirmed emergency medical condition
MC Ordering professional is not required to consult a clinical decision support mechanism due to the significant hardship exception of electronic health record or clinical decision support mechanism vendor issues
MG The order for this service does not have applicable appropriate use criteria in the qualified clinical decision support mechanism consulted by the ordering professional
26 Professional component: certain procedures are a combination of a physician or other qualified health care professional component and a technical component. when the physician or other qualified health care professional component is reported separately, the service may be identified by adding modifier 26 to the usual procedure number.
X4 Episodic/focused services: for reporting services by clinicians who provide focused care on particular types of treatment limited to a defined period and circumstance; the patient has a problem, acute or chronic, that will be treated with surgery, radiation, or some other type of generally time-limited intervention; reporting clinician service examples include but are not limited to, the orthopedic surgeon performing a knee replacement and seeing the patient through the postoperative period
MF The order for this service does not adhere to the appropriate use criteria in the clinical decision support mechanism consulted by the ordering professional
KX Requirements specified in the medical policy have been met
ME The order for this service adheres to appropriate use criteria in the clinical decision support mechanism consulted by the ordering professional
GY Item or service statutorily excluded, does not meet the definition of any medicare benefit or, for non-medicare insurers, is not a contract benefit
Q6 Service furnished under a fee-for-time compensation arrangement by a substitute physician or by a substitute physical therapist furnishing outpatient physical therapy services in a health professional shortage area, a medically underserved area, or a rural area
52 Reduced services: under certain circumstances a service or procedure is partially reduced or eliminated at the discretion of the physician or other qualified health care professional. under these circumstances the service provided can be identified by its usual procedure number and the addition of modifier 52, signifying that the service is reduced. this provides a means of reporting reduced services without disturbing the identification of the basic service. note: for hospital outpatient reporting of a previously scheduled procedure/service that is partially reduced or cancelled as a result of extenuating circumstances or those that threaten the well-being of the patient prior to or after administration of anesthesia, see modifiers 73 and 74 (see modifiers approved for asc hospital outpatient use).
59 Distinct procedural service: under certain circumstances, it may be necessary to indicate that a procedure or service was distinct or independent from other non-e/m services performed on the same day. modifier 59 is used to identify procedures/services, other than e/m services, that are not normally reported together, but are appropriate under the circumstances. documentation must support a different session, different procedure or surgery, different site or organ system, separate incision/excision, separate lesion, or separate injury (or area of injury in extensive injuries) not ordinarily encountered or performed on the same day by the same individual. however, when another already established modifier is appropriate it should be used rather than modifier 59. only if no more descriptive modifier is available, and the use of modifier 59 best explains the circumstances, should modifier 59 be used. note: modifier 59 should not be appended to an e/m service. to report a separate and distinct e/m service with a non-e/m service performed on the same date, see modifier 25.
CR Catastrophe/disaster related
XS Separate structure, a service that is distinct because it was performed on a separate organ/structure
GW Service not related to the hospice patient's terminal condition
AQ Physician providing a service in an unlisted health professional shortage area (hpsa)
QQ Ordering professional consulted a qualified clinical decision support mechanism for this service and the related data was provided to the furnishing professional
LT Left side (used to identify procedures performed on the left side of the body)
MH Unknown if ordering professional consulted a clinical decision support mechanism for this service, related information was not provided to the furnishing professional or provider
GA Waiver of liability statement issued as required by payer policy, individual case
RT Right side (used to identify procedures performed on the right side of the body)
53 Discontinued procedure: under certain circumstances, the physician or other qualified health care professional may elect to terminate a surgical or diagnostic procedure. due to extenuating circumstances or those that threaten the well being of the patient, it may be necessary to indicate that a surgical or diagnostic procedure was started but discontinued. this circumstance may be reported by adding modifier 53 to the code reported by the individual for the discontinued procedure. note: this modifier is not used to report the elective cancellation of a procedure prior to the patient's anesthesia induction and/or surgical preparation in the operating suite. for outpatient hospital/ambulatory surgery center (asc) reporting of a previously scheduled procedure/service that is partially reduced or cancelled as a result of extenuating circumstances or those that threaten the well being of the patient prior to or after administration of anesthesia, see modifiers 73 and 74 (see modifiers approved for asc hospital outpatient use).
76 Repeat procedure or service by same physician or other qualified health care professional: it may be necessary to indicate that a procedure or service was repeated by the same physician or other qualified health care professional subsequent to the original procedure or service. this circumstance may be reported by adding modifier 76 to the repeated procedure or service. note: this modifier should not be appended to an e/m service.
77 Repeat procedure by another physician or other qualified health care professional: it may be necessary to indicate that a basic procedure or service was repeated by another physician or other qualified health care professional subsequent to the original procedure or service. this circumstance may be reported by adding modifier 77 to the repeated procedure or service. note: this modifier should not be appended to an e/m service.
95 Synchronous telemedicine service rendered via a real-time interactive audio and video telecommunications system: synchronous telemedicine service is defined as a real-time interaction between a physician or other qualified health care professional and a patient who is located at a distant site from the physician or other qualified health care professional. the totality of the communication of information exchanged between the physician or other qualified health care professional and the patient during the course of the synchronous telemedicine service must be of an amount and nature that would be sufficient to meet the key components and/or requirements of the same service when rendered via a face-to-face interaction. modifier 95 may only be appended to the services listed in appendix p. appendix p is the list of cpt codes for services that are typically performed face-to-face, but may be rendered via a real-time (synchronous) interactive audio and video telecommunications system.
ET Emergency services
GV Attending physician not employed or paid under arrangement by the patient's hospice provider
PD Diagnostic or related non diagnostic item or service provided in a wholly owned or operated entity to a patient who is admitted as an inpatient within 3 days
Q0 Investigational clinical service provided in a clinical research study that is in an approved clinical research study
Q1 Routine clinical service provided in a clinical research study that is in an approved clinical research study
QJ Services/items provided to a prisoner or patient in state or local custody, however the state or local government, as applicable, meets the requirements in 42 cfr 411.4 (b)
XE Separate encounter, a service that is distinct because it occurred during a separate encounter
XP Separate practitioner, a service that is distinct because it was performed by a different practitioner
XU Unusual non-overlapping service, the use of a service that is distinct because it does not overlap usual components of the main service
Date
Action
Notes
2011-01-01 Changed Short description changed.
2003-01-01 Added First appearance in code book in 2003.
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