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Official Description

Computed tomographic angiography, upper extremity, with contrast material(s), including noncontrast images, if performed, and image postprocessing

© Copyright 2025 American Medical Association. All rights reserved.

Common Language Description

A computed tomographic angiography (CTA) of the upper extremity is a specialized imaging procedure that utilizes advanced technology to visualize the blood vessels in the arm and hand. This procedure involves the use of contrast material, which enhances the visibility of the vascular structures during imaging. The process begins with the patient being positioned on a CT table, where an intravenous line is typically inserted into a blood vessel, most commonly in the arm or hand. This line is essential for administering the contrast material, which is injected to improve the clarity of the images obtained. In some cases, non-contrast images may also be captured as part of the procedure, providing additional context and detail. The CTA employs a combination of computed tomography and angiography techniques, allowing for the acquisition of multiple images that are subsequently processed by a computer. This processing creates detailed, three-dimensional cross-sectional views of the blood vessels, which are then displayed on a computer monitor for analysis. The procedure involves a small dose of contrast material being injected at a controlled rate while the CT table moves through the CT machine, capturing the necessary images. Once the CTA is completed, a radiologist reviews and interprets the images, providing critical information that can assist in diagnosing various vascular conditions affecting the upper extremity.

© Copyright 2025 Coding Ahead. All rights reserved.

1. Indications

The computed tomographic angiography (CTA) of the upper extremity is indicated for various clinical scenarios where detailed visualization of the blood vessels is necessary. The following conditions may warrant the use of this imaging procedure:

  • Vascular Abnormalities Assessment of congenital or acquired vascular malformations, such as arteriovenous malformations or aneurysms.
  • Peripheral Vascular Disease Evaluation of conditions affecting blood flow in the upper extremities, including stenosis or occlusion of arteries.
  • Trauma Investigation of vascular injuries resulting from trauma to the arm or hand, which may require surgical intervention.
  • Preoperative Planning Providing detailed vascular mapping prior to surgical procedures involving the upper extremities.
  • Postoperative Evaluation Monitoring the status of blood vessels following surgical interventions or procedures.

2. Procedure

The procedure for performing a computed tomographic angiography (CTA) of the upper extremity involves several key steps that ensure accurate imaging and assessment of the blood vessels. The following outlines the procedural steps:

  • Step 1: Patient Preparation The patient is positioned comfortably on the CT table, ensuring that the upper extremity to be examined is accessible. An intravenous line is established, typically in the arm or hand, to facilitate the administration of contrast material.
  • Step 2: Non-Contrast Imaging If indicated, non-contrast images may be obtained first to provide baseline data. This step is crucial for comparison with the contrast-enhanced images that will follow.
  • Step 3: Contrast Administration A small dose of contrast material is injected through the intravenous line. This contrast enhances the visibility of the blood vessels during the imaging process. Test images may be taken to verify the correct positioning of the contrast material within the vascular system.
  • Step 4: CTA Imaging The CTA is performed by injecting the contrast material at a controlled rate while the CT table moves through the CT machine. This movement allows for the acquisition of multiple images from various angles, which are essential for creating detailed three-dimensional views of the blood vessels.
  • Step 5: Image Processing After the imaging is completed, the obtained images are processed using advanced computer software. This processing generates detailed cross-sectional views of the upper extremity's vascular structures.
  • Step 6: Interpretation Finally, a radiologist reviews and interprets the CTA images, providing a comprehensive analysis that can assist in diagnosing any vascular conditions present in the upper extremity.

3. Post-Procedure

After the completion of the computed tomographic angiography (CTA) of the upper extremity, the patient may be monitored briefly to ensure there are no immediate adverse reactions to the contrast material. It is common for patients to resume normal activities shortly after the procedure, as there is typically no significant recovery time required. However, patients may be advised to drink plenty of fluids to help flush the contrast material from their system. The radiologist will provide a detailed report based on the images obtained, which will be communicated to the referring physician for further evaluation and management of any identified vascular issues.

Short Descr CT ANGIO UPR EXTRM W/O&W/DYE
Medium Descr CT ANGIOGRAPHY UPPER EXTREMITY
Long Descr Computed tomographic angiography, upper extremity, with contrast material(s), including noncontrast images, if performed, and image postprocessing
Status Code Active Code
Global Days XXX - Global Concept Does Not Apply
PC/TC Indicator (26, TC) 1 - Diagnostic Tests for Radiology Services
Multiple Procedures (51) 4 - Special payment adjustment rules on the technical component (TC) of multiple diagnostic imaging 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 88 -
APC Status Indicator Codes That May Be Paid Through a Composite APC
ASC Payment Indicator Radiology service paid separately when provided integral to a surgical procedure on ASC list; payment based on OPPS relative payment weight.
Type of Service (TOS) 4 - Diagnostic Radiology
Berenson-Eggers TOS (BETOS) I2B - Advanced imaging - CAT/CT/CTA: other
MUE 2
CCS Clinical Classification 180 - Other CT scan
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.
LT Left side (used to identify procedures performed on the left side of the body)
RT Right side (used to identify procedures performed on the right side of the body)
GC This service has been performed in part by a resident under the direction of a teaching physician
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
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
50 Bilateral procedure: unless otherwise identified in the listings, bilateral procedures that are performed at the same session, should be identified by adding modifier 50 to the appropriate 5 digit code. note: this modifier should not be appended to designated "add-on" codes (see appendix d).
51 Multiple procedures: when multiple procedures, other than e/m services, physical medicine and rehabilitation services or provision of supplies (eg, vaccines), are performed at the same session by the same individual, the primary procedure or service may be reported as listed. the additional procedure(s) or service(s) may be identified by appending modifier 51 to the additional procedure or service code(s). note: this modifier should not be appended to designated "add-on" codes (see appendix d).
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).
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).
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.
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.
CR Catastrophe/disaster related
CT Computed tomography services furnished using equipment that does not meet each of the attributes of the national electrical manufacturers association (nema) xr-29-2013 standard
GA Waiver of liability statement issued as required by payer policy, individual case
GW Service not related to the hospice patient's terminal condition
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
ME The order for this service adheres to appropriate use criteria in the clinical decision support mechanism consulted by the ordering professional
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
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
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
QQ Ordering professional consulted a qualified clinical decision support mechanism for this service and the related data was provided to the furnishing professional
TC Technical component; under certain circumstances, a charge may be made for the technical component alone; under those circumstances the technical component charge is identified by adding modifier 'tc' to the usual procedure number; technical component charges are institutional charges and not billed separately by physicians; however, portable x-ray suppliers only bill for technical component and should utilize modifier tc; the charge data from portable x-ray suppliers will then be used to build customary and prevailing profiles
U6 Medicaid level of care 6, as defined by each state
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
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
XS Separate structure, a service that is distinct because it was performed on a separate organ/structure
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
2008-01-01 Changed Code description changed.
2001-01-01 Added First appearance in code book in 2001.
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