{"id":159095,"date":"2026-07-20T10:09:07","date_gmt":"2026-07-20T10:09:07","guid":{"rendered":"https:\/\/pabau.com\/?p=159095"},"modified":"2026-08-13T12:01:47","modified_gmt":"2026-08-13T12:01:47","slug":"cpt-code-71271","status":"publish","type":"post","link":"https:\/\/pabau.com\/es\/procedure-codes\/cpt-code-71271\/","title":{"rendered":"CPT Code 71271: Low-dose CT lung cancer screening"},"content":{"rendered":"\n<script type=\"application\/ld+json\">{\"@context\":\"https:\/\/schema.org\",\"@type\":\"MedicalWebPage\",\"headline\":\"CPT Code 71271: Low-dose CT lung cancer screening guide\",\"description\":\"CPT Code 71271 covers low-dose CT (LDCT) lung cancer screening. Learn Medicare eligibility criteria, reimbursement rates, modifiers, ICD-10 pairings (Z12.31, Z87.891), G0296 requirements, and billing best practices.\",\"url\":\"https:\/\/pabau.com\/procedure-codes\/cpt-code-71271\/\",\"audience\":{\"@type\":\"MedicalAudience\",\"audienceType\":\"Clinician\"},\"reviewedBy\":{\"@type\":\"Person\",\"name\":\"Dr Vanja Kitanova\",\"jobTitle\":\"Medical Reviewer\",\"affiliation\":{\"@type\":\"Organization\",\"name\":\"Pabau\"},\"knowsAbout\":[\"Medical Coding\",\"Clinical Documentation\",\"Healthcare Billing\",\"Clinical Safety\"],\"sameAs\":\"https:\/\/pabau.com\/blog\/author\/vanja\/\"},\"datePublished\":\"2026-07-20\",\"dateModified\":\"2026-07-20\"}<\/script>\n\n\n        <div id=\"key_takeaways\">\n            <div class=\"header\">\n                                    <img decoding=\"async\" src=\"https:\/\/pabau.com\/wp-content\/uploads\/2025\/12\/Key-Takeaways-Icon.svg\" alt=\"Key Takeaways\" height=\"42\" width=\"42\">\n                                <h3>Key Takeaways<\/h3>\n            <\/div>\n            <div class=\"list\">\n                                                            <div class=\"item\">\n                            <div>\n                                <svg width=\"20\" height=\"27\" viewBox=\"0 0 20 27\" fill=\"none\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\">\n                                    <path\n                                        d=\"M18.6223 14.3857C19.1246 13.8975 19.1246 13.1045 18.6223 12.6162L12.1938 6.36621C11.6915 5.87793 10.8759 5.87793 10.3737 6.36621C9.87143 6.85449 9.87143 7.64746 10.3737 8.13574L14.6125 12.2529H2.28571C1.57455 12.2529 1 12.8115 1 13.5029C1 14.1943 1.57455 14.7529 2.28571 14.7529H14.6085L10.3777 18.8701C9.87545 19.3584 9.87545 20.1514 10.3777 20.6396C10.8799 21.1279 11.6955 21.1279 12.1978 20.6396L18.6263 14.3896L18.6223 14.3857Z\"\n                                        fill=\"#3D3D46\" \/>\n                                <\/svg>\n                            <\/div>\n                            <p>CPT Code 71271 describes a low-dose CT (LDCT) scan of the thorax performed for annual lung cancer screening in high-risk patients.<\/p>\n                        <\/div>\n                                                                                <div class=\"item\">\n                            <div>\n                                <svg width=\"20\" height=\"27\" viewBox=\"0 0 20 27\" fill=\"none\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\">\n                                    <path\n                                        d=\"M18.6223 14.3857C19.1246 13.8975 19.1246 13.1045 18.6223 12.6162L12.1938 6.36621C11.6915 5.87793 10.8759 5.87793 10.3737 6.36621C9.87143 6.85449 9.87143 7.64746 10.3737 8.13574L14.6125 12.2529H2.28571C1.57455 12.2529 1 12.8115 1 13.5029C1 14.1943 1.57455 14.7529 2.28571 14.7529H14.6085L10.3777 18.8701C9.87545 19.3584 9.87545 20.1514 10.3777 20.6396C10.8799 21.1279 11.6955 21.1279 12.1978 20.6396L18.6263 14.3896L18.6223 14.3857Z\"\n                                        fill=\"#3D3D46\" \/>\n                                <\/svg>\n                            <\/div>\n                            <p>Medicare covers this code annually for patients aged 50-77 with a 20 pack-year smoking history who are current smokers or quit within the past 15 years.<\/p>\n                        <\/div>\n                                                                                <div class=\"item\">\n                            <div>\n                                <svg width=\"20\" height=\"27\" viewBox=\"0 0 20 27\" fill=\"none\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\">\n                                    <path\n                                        d=\"M18.6223 14.3857C19.1246 13.8975 19.1246 13.1045 18.6223 12.6162L12.1938 6.36621C11.6915 5.87793 10.8759 5.87793 10.3737 6.36621C9.87143 6.85449 9.87143 7.64746 10.3737 8.13574L14.6125 12.2529H2.28571C1.57455 12.2529 1 12.8115 1 13.5029C1 14.1943 1.57455 14.7529 2.28571 14.7529H14.6085L10.3777 18.8701C9.87545 19.3584 9.87545 20.1514 10.3777 20.6396C10.8799 21.1279 11.6955 21.1279 12.1978 20.6396L18.6263 14.3896L18.6223 14.3857Z\"\n                                        fill=\"#3D3D46\" \/>\n                                <\/svg>\n                            <\/div>\n                            <p>HCPCS G0296 (shared decision-making visit) must be billed before the first annual LDCT screening; subsequent annual screenings do not require a repeat G0296.<\/p>\n                        <\/div>\n                                                                                <div class=\"item\">\n                            <div>\n                                <svg width=\"20\" height=\"27\" viewBox=\"0 0 20 27\" fill=\"none\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\">\n                                    <path\n                                        d=\"M18.6223 14.3857C19.1246 13.8975 19.1246 13.1045 18.6223 12.6162L12.1938 6.36621C11.6915 5.87793 10.8759 5.87793 10.3737 6.36621C9.87143 6.85449 9.87143 7.64746 10.3737 8.13574L14.6125 12.2529H2.28571C1.57455 12.2529 1 12.8115 1 13.5029C1 14.1943 1.57455 14.7529 2.28571 14.7529H14.6085L10.3777 18.8701C9.87545 19.3584 9.87545 20.1514 10.3777 20.6396C10.8799 21.1279 11.6955 21.1279 12.1978 20.6396L18.6263 14.3896L18.6223 14.3857Z\"\n                                        fill=\"#3D3D46\" \/>\n                                <\/svg>\n                            <\/div>\n                            <p>Pabau&#8217;s claims management software helps radiology and primary care practices document eligibility criteria, track G0296 completion, and submit LDCT claims accurately.<\/p>\n                        <\/div>\n                                                <\/div>\n        <\/div>\n    \n\n\n<p class=\"wp-block-paragraph\">Missed eligibility documentation is the top reason CPT Code 71271 claims get denied. Medicare&#8217;s lung cancer screening benefit has strict requirements: age, smoking history, symptom status, and a completed shared decision-making visit must all be confirmed before you submit. Skip any one of them and the claim comes back unpaid.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">This reference guide covers what CPT Code 71271 is, who qualifies under Medicare, how to pair it with the right ICD-10 codes, current reimbursement rates, applicable modifiers, and the documentation checklist that keeps claims clean. It also covers commercial payer rules and the most common denial patterns billers encounter.<\/p>\n\n\n\n<figure class=\"wp-block-embed is-type-video is-provider-youtube wp-block-embed-youtube wp-embed-aspect-16-9 wp-has-aspect-ratio\"><div class=\"wp-block-embed__wrapper\">\n<iframe title=\"CPT Coding Pitfalls Every Medical Practice Faces\" width=\"800\" height=\"450\" src=\"https:\/\/www.youtube.com\/embed\/vbvV5okdXKg?feature=oembed\" frameborder=\"0\" allow=\"accelerometer; autoplay; clipboard-write; encrypted-media; gyroscope; picture-in-picture; web-share\" referrerpolicy=\"strict-origin-when-cross-origin\" allowfullscreen><\/iframe>\n<\/div><\/figure>\n\n\n\n<h2 id=\"h-cpt-code-71271-definition-and-clinical-description\" class=\"wp-block-heading\">CPT Code 71271: Definition and clinical description<\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">CPT Code 71271 is assigned to computed tomography (CT) of the thorax, low dose, for lung cancer screening, without contrast material. The American Medical Association maintains this code in the <a href=\"https:\/\/www.ama-assn.org\/practice-management\/cpt\/cpt-code-set-overview\" target=\"_blank\" rel=\"nofollow noopener\">AMA&#8217;s CPT code set<\/a>, categorizing it within the Diagnostic Radiology section.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Low-dose CT delivers significantly less ionizing radiation than a diagnostic chest CT, typically 1-2 millisieverts versus 7-8 mSv for a full diagnostic scan. The procedure takes fewer than 10 minutes and requires no intravenous contrast. It images the lungs, mediastinum, and surrounding thoracic structures well enough to detect nodules as small as a few millimeters.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">The clinical rationale is strong. The National Lung Screening Trial found that annual LDCT reduced lung cancer mortality by 20% in high-risk populations compared with chest X-ray.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">That trial directly supported the U.S. Preventive Services Task Force (USPSTF) issuing a Grade B recommendation for LDCT screening, which in turn triggered the ACA coverage mandate for commercial insurers and Medicare coverage through CMS National Coverage Determination (NCD) 210.14.<\/p>\n\n\n\n<table style=\"width:100%;border-collapse:separate;border-spacing:0;border-radius:12px;overflow:hidden;font-size:15px;line-height:1.5;margin:1.5em 0 2em;box-shadow:0 2px 12px rgba(0,0,0,0.08)\">\n<thead>\n<tr>\n<th style=\"background:#121D36;color:#fff;padding:14px 16px;text-align:left;font-weight:600;font-size:14px;letter-spacing:0.3px;border-bottom:2px solid #2BADD4\">Field<\/th>\n<th style=\"background:#121D36;color:#fff;padding:14px 16px;text-align:left;font-weight:600;font-size:14px;letter-spacing:0.3px;border-bottom:2px solid #2BADD4\">Detail<\/th>\n<\/tr>\n<\/thead>\n<tbody>\n<tr style=\"border-bottom:1px solid #E8ECF0\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">Code<\/td>\n<td style=\"padding:12px 16px;color:#374151\">71271<\/td>\n<\/tr>\n<tr style=\"border-bottom:1px solid #E8ECF0;background:#F9FAFB\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">Full descriptor<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Computed tomography, thorax, low dose; for lung cancer screening, without contrast material(s)<\/td>\n<\/tr>\n<tr style=\"border-bottom:1px solid #E8ECF0\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">Code type<\/td>\n<td style=\"padding:12px 16px;color:#374151\">CPT Category I<\/td>\n<\/tr>\n<tr style=\"border-bottom:1px solid #E8ECF0;background:#F9FAFB\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">Radiology subsection<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Diagnostic Radiology (Diagnostic Imaging) of the Chest<\/td>\n<\/tr>\n<tr style=\"border-bottom:1px solid #E8ECF0\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">Contrast<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Without contrast only (no with-contrast or with-and-without variant)<\/td>\n<\/tr>\n<tr style=\"border-bottom:1px solid #E8ECF0;background:#F9FAFB\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">Companion HCPCS code<\/td>\n<td style=\"padding:12px 16px;color:#374151\">G0296 (shared decision-making visit, required before first annual screening)<\/td>\n<\/tr>\n<tr style=\"border-bottom:1px solid #E8ECF0\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">Medicare benefit category<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Preventive Services (no beneficiary cost-sharing for qualified patients)<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n\n\n\n<h2 id=\"h-medicare-eligibility-criteria-for-cpt-code-71271\" class=\"wp-block-heading\">Medicare eligibility criteria for CPT Code 71271<\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">CMS updated the Medicare lung cancer screening eligibility criteria in February 2022 via a revision to NCD 210.14, expanding the age range from 55-77 to 50-77. That change brought Medicare&#8217;s criteria into alignment with the USPSTF&#8217;s 2021 updated recommendation. Confirm the current NCD text at <a href=\"https:\/\/www.cms.gov\/medicare\/physician-fee-schedule\/search\/overview\" target=\"_blank\" rel=\"nofollow noopener\">CMS&#8217;s Physician Fee Schedule<\/a> before billing for any patient near the age boundaries.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">All five criteria below must be documented in the medical record before billing CPT Code 71271. A single missing element can trigger a medical necessity denial.<\/p>\n\n\n\n<table style=\"width:100%;border-collapse:separate;border-spacing:0;border-radius:12px;overflow:hidden;font-size:15px;line-height:1.5;margin:1.5em 0 2em;box-shadow:0 2px 12px rgba(0,0,0,0.08)\">\n<thead>\n<tr>\n<th style=\"background:#121D36;color:#fff;padding:14px 16px;text-align:left;font-weight:600;font-size:14px;letter-spacing:0.3px;border-bottom:2px solid #2BADD4\">Criterion<\/th>\n<th style=\"background:#121D36;color:#fff;padding:14px 16px;text-align:left;font-weight:600;font-size:14px;letter-spacing:0.3px;border-bottom:2px solid #2BADD4\">Requirement<\/th>\n<th style=\"background:#121D36;color:#fff;padding:14px 16px;text-align:left;font-weight:600;font-size:14px;letter-spacing:0.3px;border-bottom:2px solid #2BADD4\">Documentation note<\/th>\n<\/tr>\n<\/thead>\n<tbody>\n<tr style=\"border-bottom:1px solid #E8ECF0\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">Age<\/td>\n<td style=\"padding:12px 16px;color:#374151\">50-77 years<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Date of birth verified against Medicare record<\/td>\n<\/tr>\n<tr style=\"border-bottom:1px solid #E8ECF0;background:#F9FAFB\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">Smoking history<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Minimum 20 pack-years (current or former smoker)<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Pack-year calculation documented in the order or progress note<\/td>\n<\/tr>\n<tr style=\"border-bottom:1px solid #E8ECF0\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">Smoking status<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Current smoker OR former smoker who quit within the past 15 years<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Note the quit date for former smokers; confirm within 15-year window<\/td>\n<\/tr>\n<tr style=\"border-bottom:1px solid #E8ECF0;background:#F9FAFB\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">Symptom status<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Asymptomatic (no signs or symptoms of lung cancer)<\/td>\n<td style=\"padding:12px 16px;color:#374151\">If symptoms are present, order a diagnostic CT instead<\/td>\n<\/tr>\n<tr style=\"border-bottom:1px solid #E8ECF0\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">Shared decision-making<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Written order from a physician or qualified NPP following a shared decision-making visit (G0296)<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Required before the first annual screening only<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n\n\n\n<p class=\"wp-block-paragraph\">Practices that manage multiple preventive screenings can benefit from structured eligibility checklists embedded directly in their digital intake forms, so no criterion is overlooked before the order is placed.<\/p>\n\n\n\n<figure class=\"wp-block-image size-large\"><img decoding=\"async\" src=\"https:\/\/cdn.pabau.com\/cdn\/attachments\/pulse\/content-engine\/billing_codes\/cpt-code-71271\/customizable-consent-and-intake-forms.webp\" alt=\"Customizable consent and intake forms\"\/><figcaption class=\"wp-element-caption\"><em>Customizable consent and intake forms<\/em><\/figcaption><\/figure>\n\n\n\n<div style=\"height:20px\" aria-hidden=\"true\" class=\"wp-block-spacer\"><\/div>\n\n\n\n<h2 id=\"h-shared-decision-making-requirement-hcpcs-g0296\" class=\"wp-block-heading\">Shared decision-making requirement: HCPCS G0296<\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">HCPCS G0296 is the companion code for the shared decision-making (SDM) counseling visit that CMS requires before a beneficiary&#8217;s first annual lung cancer screening. Without a G0296 on file for the first-time screen, Medicare will deny the 71271 claim.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">The G0296 visit must cover specific content. CMS requires the clinician to:<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li>Discuss the benefits, limitations, and harms of LDCT screening<\/li>\n\n\n\n<li>Record the patient&#8217;s smoking history<\/li>\n\n\n\n<li>Document follow-up and referral plans if nodules are found<\/li>\n<\/ul>\n\n\n\n<p class=\"wp-block-paragraph\">The visit can be performed by a physician, nurse practitioner, physician assistant, or clinical nurse specialist.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">A critical nuance: G0296 is only required before the <strong>first<\/strong> annual screening. Subsequent annual screenings do not require a repeat SDM visit. Billing G0296 every year is incorrect and may trigger an audit flag. Structured compliance tracking tools help practices flag whether a patient has already had a qualifying G0296 visit before generating a new order.<\/p>\n\n\n\n<div style=\"height:20px\" aria-hidden=\"true\" class=\"wp-block-spacer\"><\/div>\n\n\n\n<h3 id=\"h-g0296-billing-guidance\" class=\"wp-block-heading\">G0296 billing guidance<\/h3>\n\n\n\n<ul class=\"wp-block-list\">\n<li>Bill G0296 on the same date of service as the SDM visit, separate from the E\/M code for that visit<\/li>\n\n\n\n<li>G0296 can be billed by the ordering provider or facility that performs the SDM visit<\/li>\n\n\n\n<li>No modifier is needed for G0296 on its own. It&#8217;s covered as a preventive benefit with no cost-sharing for the beneficiary<\/li>\n\n\n\n<li>Document the SDM note separately from the general visit note. Payers may request it on audit<\/li>\n\n\n\n<li>Once G0296 is billed for a patient&#8217;s first screening cycle, record the date in the patient record to avoid duplicate billing in future years<\/li>\n<\/ul>\n\n\n\n<p class=\"wp-block-paragraph\">A <a href=\"https:\/\/pabau.com\/features\/medical-lab-software\/\">lab and diagnostics integration<\/a> keeps radiology results attached to the visit that ordered them.<\/p>\n\n\n\n<h2 id=\"h-icd-10-diagnosis-codes-to-pair-with-cpt-71271\" class=\"wp-block-heading\">ICD-10 diagnosis codes to pair with CPT 71271<\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">Accurate diagnosis code pairing is essential for claim acceptance. Medicare requires at least one ICD-10 code that establishes medical necessity for a preventive lung cancer screening. Using the wrong code (such as a sign or symptom code rather than a screening code) will misclassify the service as diagnostic, changing the patient&#8217;s cost-sharing responsibility and potentially triggering a denial.<\/p>\n\n\n\n<table style=\"width:100%;border-collapse:separate;border-spacing:0;border-radius:12px;overflow:hidden;font-size:15px;line-height:1.5;margin:1.5em 0 2em;box-shadow:0 2px 12px rgba(0,0,0,0.08)\">\n<thead>\n<tr>\n<th style=\"background:#121D36;color:#fff;padding:14px 16px;text-align:left;font-weight:600;font-size:14px;letter-spacing:0.3px;border-bottom:2px solid #2BADD4\">ICD-10 Code<\/th>\n<th style=\"background:#121D36;color:#fff;padding:14px 16px;text-align:left;font-weight:600;font-size:14px;letter-spacing:0.3px;border-bottom:2px solid #2BADD4\">Description<\/th>\n<th style=\"background:#121D36;color:#fff;padding:14px 16px;text-align:left;font-weight:600;font-size:14px;letter-spacing:0.3px;border-bottom:2px solid #2BADD4\">Usage<\/th>\n<\/tr>\n<\/thead>\n<tbody>\n<tr style=\"border-bottom:1px solid #E8ECF0\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">Z12.31<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Encounter for screening for malignant neoplasm of lung<\/td>\n<td style=\"padding:12px 16px;color:#374151\"><strong>Primary code<\/strong> &#8211; use on every qualifying LDCT claim<\/td>\n<\/tr>\n<tr style=\"border-bottom:1px solid #E8ECF0;background:#F9FAFB\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">Z87.891<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Personal history of nicotine dependence<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Secondary code for former smokers; supports eligibility documentation<\/td>\n<\/tr>\n<tr style=\"border-bottom:1px solid #E8ECF0\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">F17.210<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Nicotine dependence, cigarettes, uncomplicated<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Secondary code for current smokers (active nicotine dependence)<\/td>\n<\/tr>\n<tr style=\"border-bottom:1px solid #E8ECF0;background:#F9FAFB\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">F17.211<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Nicotine dependence, cigarettes, in remission<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Use for former smokers actively in a cessation program<\/td>\n<\/tr>\n<tr style=\"border-bottom:1px solid #E8ECF0\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">Z77.098<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Contact with and (suspected) exposure to other hazardous, chiefly nonmedicinal, chemicals<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Optional secondary for occupational exposure history (e.g. asbestos)<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n\n\n\n<p class=\"wp-block-paragraph\">Use the <a href=\"https:\/\/crosscoder.com\/\" target=\"_blank\" rel=\"nofollow noopener\">CrossCoder CPT-to-ICD-10 crosswalk tool<\/a> to verify current payer-accepted pairings before submitting. Some Medicare Administrative Contractors (MACs) publish Local Coverage Determinations (LCDs) that specify acceptable ICD-10 codes for 71271 in their jurisdiction. Always check your MAC&#8217;s LCD in addition to the national NCD.<\/p>\n\n\n\n<h2 id=\"h-cpt-71271-reimbursement-rates\" class=\"wp-block-heading\">CPT 71271 reimbursement rates<\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">Medicare reimbursement for CPT Code 71271 is calculated from the CMS Physician Fee Schedule (PFS), which updates annually each January. The rates below reflect general 2025 figures based on CMS PFS data. Verify current amounts using the <a href=\"https:\/\/fastrvu.com\/tools\/rvu-lookup\" target=\"_blank\" rel=\"nofollow noopener\">FastRVU lookup tool<\/a> or the CMS PFS search before billing, as rates change year to year and vary by geographic region.<\/p>\n\n\n\n<table style=\"width:100%;border-collapse:separate;border-spacing:0;border-radius:12px;overflow:hidden;font-size:15px;line-height:1.5;margin:1.5em 0 2em;box-shadow:0 2px 12px rgba(0,0,0,0.08)\">\n<thead>\n<tr>\n<th style=\"background:#121D36;color:#fff;padding:14px 16px;text-align:left;font-weight:600;font-size:14px;letter-spacing:0.3px;border-bottom:2px solid #2BADD4\">Setting<\/th>\n<th style=\"background:#121D36;color:#fff;padding:14px 16px;text-align:left;font-weight:600;font-size:14px;letter-spacing:0.3px;border-bottom:2px solid #2BADD4\">Approximate national average<\/th>\n<th style=\"background:#121D36;color:#fff;padding:14px 16px;text-align:left;font-weight:600;font-size:14px;letter-spacing:0.3px;border-bottom:2px solid #2BADD4\">Components included<\/th>\n<\/tr>\n<\/thead>\n<tbody>\n<tr style=\"border-bottom:1px solid #E8ECF0\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">Non-facility (outpatient office)<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Approximately $100-$130<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Work RVU + non-facility PE RVU + MP RVU<\/td>\n<\/tr>\n<tr style=\"border-bottom:1px solid #E8ECF0;background:#F9FAFB\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">Facility (hospital \/ IDTF)<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Approximately $50-$75 (professional component)<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Work RVU + facility PE RVU + MP RVU<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n\n\n\n<p class=\"wp-block-paragraph\">Geographic Practice Cost Indices (GPCIs) adjust these national averages by locality. A radiology practice in Manhattan will receive a higher payment than one in rural Mississippi for the same code. Actual payments may also vary based on whether the practice has accepted Medicare assignment.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Medicare covers CPT Code 71271 with no cost-sharing for the beneficiary when all eligibility criteria are met. That zero-cost-share status applies only to the screening service itself.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">If a nodule is found and a follow-up diagnostic CT is ordered, that subsequent scan carries standard Medicare cost-sharing rules and would be billed under a different CPT code (such as 71250 or 71270).<\/p>\n\n\n        <div id=\"pro_tip\">\n            <div class=\"img\">\n                <svg width=\"42\" height=\"42\" viewBox=\"0 0 42 42\" fill=\"none\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\">\n                    <path fill-rule=\"evenodd\" clip-rule=\"evenodd\"\n                        d=\"M12.6383 19.5238C12.6632 21.2071 12.8734 22.9926 12.0685 24.5523C11.0341 26.8917 8.45076 28.169 7.56292 30.5918C6.63082 33.1061 7.19505 36.185 9.31371 37.9786C10.929 39.5678 13.4183 39.9873 15.6061 39.5463C17.4592 39.073 19.1049 37.8388 19.9706 36.1608C20.781 34.7141 20.7866 32.9904 20.5293 31.3985C20.1006 29.3092 18.3775 27.8705 16.9807 26.362C14.8814 24.1005 14.6684 20.6854 15.595 17.8915C16.4331 15.4768 19.0026 14.2344 20.0425 11.9461C20.7202 10.6769 20.7506 9.20327 20.6068 7.81304C20.1864 5.40098 18.3139 3.23631 15.8716 2.56674C13.9742 2.03969 11.8224 2.30052 10.1739 3.37614C8.70522 4.34688 7.5878 5.86618 7.28356 7.58178C6.76081 9.82981 7.53525 12.2822 9.20307 13.9118C10.7658 15.4741 12.4806 17.2273 12.6383 19.5238Z\"\n                        fill=\"#2BADD4\" \/>\n                    <path fill-rule=\"evenodd\" clip-rule=\"evenodd\"\n                        d=\"M22.7048 19.8387C22.6822 22.3279 24.4507 24.6234 26.7493 25.4682C28.0531 25.961 29.4725 25.9183 30.7989 25.5487C32.0575 24.9955 33.301 24.2237 34.0069 23.0092C34.8384 21.5811 35.2982 19.8286 34.7832 18.2094C34.3611 16.2507 32.8739 14.6541 31.0275 13.9426C28.6736 12.9595 25.8073 13.7942 24.1719 15.7001C23.2022 16.8366 22.6143 18.3326 22.7048 19.8387Z\"\n                        fill=\"#2BADD4\" \/>\n                <\/svg>\n            <\/div>\n            <div class=\"text\">\n                <h3>Pro Tip<\/h3>\n                <p>Verify your exact local reimbursement rate using the CMS Physician Fee Schedule search before annual contract negotiations with payors. The national average can differ from your MAC locality rate by 15-25%, and billing teams that use the national figure for internal projections often discover shortfalls at reconciliation.<\/p>\n            <\/div>\n        <\/div>\n    \n\n\n<h2 id=\"h-applicable-modifiers-for-cpt-code-71271\" class=\"wp-block-heading\">Applicable modifiers for CPT Code 71271<\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">Applying the wrong modifier (or omitting a required one) on a CPT Code 71271 claim is one of the fastest routes to a denial or a reduced payment. The modifiers below are the ones coders encounter most often for LDCT lung cancer screening.<\/p>\n\n\n\n<table style=\"width:100%;border-collapse:separate;border-spacing:0;border-radius:12px;overflow:hidden;font-size:15px;line-height:1.5;margin:1.5em 0 2em;box-shadow:0 2px 12px rgba(0,0,0,0.08)\">\n<thead>\n<tr>\n<th style=\"background:#121D36;color:#fff;padding:14px 16px;text-align:left;font-weight:600;font-size:14px;letter-spacing:0.3px;border-bottom:2px solid #2BADD4\">Modifier<\/th>\n<th style=\"background:#121D36;color:#fff;padding:14px 16px;text-align:left;font-weight:600;font-size:14px;letter-spacing:0.3px;border-bottom:2px solid #2BADD4\">Name<\/th>\n<th style=\"background:#121D36;color:#fff;padding:14px 16px;text-align:left;font-weight:600;font-size:14px;letter-spacing:0.3px;border-bottom:2px solid #2BADD4\">When to apply<\/th>\n<\/tr>\n<\/thead>\n<tbody>\n<tr style=\"border-bottom:1px solid #E8ECF0\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">TC<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Technical Component<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Billing facility performs the scan but a separate radiologist reads it; bill TC for the scan equipment and tech staff<\/td>\n<\/tr>\n<tr style=\"border-bottom:1px solid #E8ECF0;background:#F9FAFB\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">26<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Professional Component<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Radiologist bills for the interpretation only, separate from the facility performing the scan<\/td>\n<\/tr>\n<tr style=\"border-bottom:1px solid #E8ECF0\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">33<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Preventive Service<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Commercial insurers subject to ACA Section 2713; signals no patient cost-sharing applies. Verify payer policy before applying.<\/td>\n<\/tr>\n<tr style=\"border-bottom:1px solid #E8ECF0;background:#F9FAFB\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">77<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Repeat Procedure by Another Physician or Other Qualified Health Care Professional<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Use if the patient requires a repeat LDCT in the same year performed by a different provider; rare scenario<\/td>\n<\/tr>\n<tr style=\"border-bottom:1px solid #E8ECF0\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">59<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Distinct Procedural Service<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Use when 71271 is performed on the same day as another thoracic CT service to indicate the LDCT screening is a separate, distinct service<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n\n\n\n<p class=\"wp-block-paragraph\">A note on modifiers LT and RT: these laterality modifiers do not apply to 71271. A CT of the thorax images both lungs simultaneously, and appending LT or RT to this code is an error that can trigger a claim rejection.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Use the <a href=\"https:\/\/www.aapc.com\/codes\/cpt-codes-range\/\" target=\"_blank\" rel=\"nofollow noopener\">AAPC CPT code reference<\/a> to review modifier applicability for radiology codes if you have questions about a specific scenario.<\/p>\n\n\n        <div id=\"book_a_demo\">\n            <div class=\"left-side\">\n                <div class=\"logo\">\n                    <img decoding=\"async\"\n                        src=\"https:\/\/pabau.com\/wp-content\/uploads\/2026\/01\/Logo.svg\"\n                        alt=\"Logo\"\n                        loading=\"lazy\"\n                    \/>\n                <\/div>\n\n                <h3 class=\"heading\">\n                    Keep your LDCT billing accurate and audit-ready                <\/h3>\n\n                <p class=\"description\">\n                    Pabau&#8217;s claims management workflows help radiology and primary care practices track eligibility criteria, monitor G0296 completion status, and submit cleaner claims for preventive services like CPT 71271.                <\/p>\n\n                <div class=\"button-group\">\n                    <a href=\"\/book-demo\/\" class=\"btn btn-scale-effect btn-cta-color btn-md\">\n                        <span class=\"btn-text\">Book a demo<\/span>\n                        <div class=\"btn-icon btn-icon-right\" aria-hidden=\"true\">\n                            <svg\n                                width=\"14\"\n                                height=\"12\"\n                                viewBox=\"0 0 14 12\"\n                                fill=\"none\"\n                                xmlns=\"http:\/\/www.w3.org\/2000\/svg\"\n                            >\n                                <path\n                                    d=\"M0.75 4.77295C0.335786 4.77295 0 5.10874 0 5.52295C0 5.93716 0.335786 6.27295 0.75 6.27295V5.52295V4.77295ZM13.2803 6.05328C13.5732 5.76039 13.5732 5.28551 13.2803 4.99262L8.50736 0.219648C8.21447 -0.073245 7.73959 -0.073245 7.4467 0.219648C7.15381 0.512542 7.15381 0.987415 7.4467 1.28031L11.6893 5.52295L7.4467 9.76559C7.15381 10.0585 7.15381 10.5334 7.4467 10.8263C7.73959 11.1191 8.21447 11.1191 8.50736 10.8263L13.2803 6.05328ZM0.75 5.52295V6.27295L12.75 6.27295V5.52295V4.77295L0.75 4.77295V5.52295Z\"\n                                    fill=\"currentColor\"\n                                ><\/path>\n                            <\/svg>\n                        <\/div>\n                    <\/a>\n                <\/div>\n            <\/div>\n\n            <div class=\"right-side\">\n                <img decoding=\"async\"\n                    src=\"https:\/\/pabau.com\/wp-content\/uploads\/2026\/01\/Home-Page-Concept-4.webp\"\n                    alt=\"Pabau claims management dashboard\"\n                    loading=\"lazy\"\n                \/>\n            <\/div>\n        <\/div>\n        \n\n\n<h2 id=\"h-documentation-requirements-for-billing-cpt-71271\" class=\"wp-block-heading\">Documentation requirements for billing CPT 71271<\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">A clean 71271 claim depends on documentation assembled before the patient ever enters the scanner. Medicare audits for this code commonly focus on whether the medical record demonstrates each eligibility element independently, not just infers it. Radiology practices that rely on a referring physician&#8217;s order alone, without verifying the clinical details, carry significant audit risk.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">The following checklist reflects CMS NCD 210.14 requirements. Practices using structured medical documentation forms can embed each element as a required field, making incomplete records impossible to submit.<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li><strong>Physician or qualified NPP order:<\/strong> Written order specifying the LDCT for lung cancer screening, signed by a licensed physician, NP, PA, or CNS<\/li>\n\n\n\n<li><strong>Age confirmation:<\/strong> Date of birth verified; patient falls within the 50-77 age range as of the date of service<\/li>\n\n\n\n<li><strong>Pack-year calculation:<\/strong> Number of packs per day multiplied by years smoked, documented to confirm minimum 20 pack-years<\/li>\n\n\n\n<li><strong>Smoking status:<\/strong> Current smoker, or former smoker with documented quit date within 15 years of the screening date<\/li>\n\n\n\n<li><strong>Asymptomatic status:<\/strong> Clinician note confirming no current signs or symptoms of lung cancer (hemoptysis, unexplained weight loss, new cough, etc.)<\/li>\n\n\n\n<li><strong>G0296 completion record:<\/strong> SDM visit note documenting benefits, harms, follow-up protocol discussion, and patient acknowledgment (required for first annual screening only)<\/li>\n\n\n\n<li><strong>Lung-RADS report:<\/strong> Radiologist&#8217;s report structured to the American College of Radiology Lung-RADS reporting standard; documents nodule findings, Lung-RADS category, and follow-up recommendations<\/li>\n<\/ul>\n\n\n\n<p class=\"wp-block-paragraph\">Practices integrating claims management software can automate pre-submission checks that flag missing documentation before a claim is transmitted, significantly reducing denial rates for preventive service codes like CPT Code 71271. Pairing this with HIPAA-compliant documentation workflows also protects patient data through the billing process.<\/p>\n\n\n\n<figure class=\"wp-block-image size-large\"><img decoding=\"async\" src=\"https:\/\/cdn.pabau.com\/cdn\/attachments\/pulse\/content-engine\/billing_codes\/cpt-code-71271\/automate-claims-through-healthcode.webp\" alt=\"Automate claims and billing with Pabau\"\/><figcaption class=\"wp-element-caption\"><em>Automate claims and billing with Pabau<\/em><\/figcaption><\/figure>\n\n\n\n<div style=\"height:20px\" aria-hidden=\"true\" class=\"wp-block-spacer\"><\/div>\n\n\n\n<h2 id=\"h-commercial-and-private-payer-coverage\" class=\"wp-block-heading\">Commercial and private payer coverage<\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">Under ACA Section 2713, commercial health plans subject to the Affordable Care Act must cover USPSTF Grade B preventive services without cost-sharing. Because LDCT lung cancer screening holds a USPSTF Grade B recommendation, most commercial insurers cover CPT Code 71271 at no cost to the patient, provided the patient meets the eligibility criteria.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Coverage details vary by payer and plan type. Grandfathered health plans (those that existed before the ACA and have not made significant changes) are not required to comply with the cost-sharing waiver. Self-insured ERISA plans may have different obligations. Short-term health plans are generally exempt from ACA preventive service requirements.<\/p>\n\n\n\n<h3 id=\"h-key-commercial-payer-considerations\" class=\"wp-block-heading\">Key commercial payer considerations<\/h3>\n\n\n\n<ul class=\"wp-block-list\">\n<li><strong>Prior authorization:<\/strong> Varies significantly by payer. Some commercial insurers require prior auth for LDCT even when it meets USPSTF criteria. Always check the payer&#8217;s policy before scheduling. See Pabau&#8217;s primary care compliance checklist for broader prior auth workflows.<\/li>\n\n\n\n<li><strong>Modifier 33:<\/strong> Some commercial payers require modifier 33 (Preventive Service) on the 71271 claim to signal the ACA cost-sharing waiver applies. This is payer-specific; verify before applying.<\/li>\n\n\n\n<li><strong>Network status:<\/strong> Facilities performing LDCT must be in-network for the cost-sharing waiver to apply. Out-of-network LDCT scans may carry standard cost-sharing even if the service is preventive.<\/li>\n\n\n\n<li><strong>Age range variation:<\/strong> Some commercial plans have adopted broader eligibility (beginning at age 50) while others retain the older USPSTF threshold. Confirm the plan&#8217;s current policy directly.<\/li>\n<\/ul>\n\n\n\n<h2 id=\"h-common-billing-errors-and-denial-prevention\" class=\"wp-block-heading\">Common billing errors and denial prevention<\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">Denial patterns for CPT Code 71271 are predictable. The same five errors appear repeatedly across billing departments, and each one is preventable with the right workflow controls in place. Practices that automate their pre-claim verification catch most of these before transmission.<\/p>\n\n\n\n<table style=\"width:100%;border-collapse:separate;border-spacing:0;border-radius:12px;overflow:hidden;font-size:15px;line-height:1.5;margin:1.5em 0 2em;box-shadow:0 2px 12px rgba(0,0,0,0.08)\">\n<thead>\n<tr>\n<th style=\"background:#121D36;color:#fff;padding:14px 16px;text-align:left;font-weight:600;font-size:14px;letter-spacing:0.3px;border-bottom:2px solid #2BADD4\">Error<\/th>\n<th style=\"background:#121D36;color:#fff;padding:14px 16px;text-align:left;font-weight:600;font-size:14px;letter-spacing:0.3px;border-bottom:2px solid #2BADD4\">What goes wrong<\/th>\n<th style=\"background:#121D36;color:#fff;padding:14px 16px;text-align:left;font-weight:600;font-size:14px;letter-spacing:0.3px;border-bottom:2px solid #2BADD4\">Prevention<\/th>\n<\/tr>\n<\/thead>\n<tbody>\n<tr style=\"border-bottom:1px solid #E8ECF0\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">Missing G0296<\/td>\n<td style=\"padding:12px 16px;color:#374151\">First annual 71271 submitted without a corresponding G0296 on file<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Flag first-time screeners in the scheduling system; block claim generation until G0296 date is recorded<\/td>\n<\/tr>\n<tr style=\"border-bottom:1px solid #E8ECF0;background:#F9FAFB\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">Wrong ICD-10 code<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Using a symptom code (R05.9, R04.2) instead of Z12.31 reclassifies the service as diagnostic<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Build a payer-crosswalk that requires Z12.31 as the primary diagnosis for all 71271 claims<\/td>\n<\/tr>\n<tr style=\"border-bottom:1px solid #E8ECF0\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">Annual frequency exceeded<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Submitting 71271 more than once per 12-month period for the same patient<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Track last-screening date in the patient record; alert when a new order is within 12 months of the last claim<\/td>\n<\/tr>\n<tr style=\"border-bottom:1px solid #E8ECF0;background:#F9FAFB\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">Patient not meeting eligibility<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Age outside 50-77, smoking history under 20 pack-years, or patient is symptomatic<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Eligibility verification step embedded in the ordering workflow; not just at the billing stage<\/td>\n<\/tr>\n<tr style=\"border-bottom:1px solid #E8ECF0\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">Missing physician order<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Radiology facility submits 71271 without a documented written order from a qualified provider<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Require order attachment or order number at time of scheduling; do not scan without it<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n\n\n\n<h2 class=\"wp-block-heading\">Related CPT codes<\/h2>\n\n\n\n<ul class=\"wp-block-list\">\n<li><a href=\"https:\/\/pabau.com\/procedure-codes\/cpt-code-76000\/\">CPT code 76000 \u2014 Fluoroscopy<\/a><\/li>\n\n\n<li><a href=\"https:\/\/pabau.com\/procedure-codes\/cpt-code-72141\/\">CPT code 72141 \u2014 MRI cervical spine without contrast<\/a><\/li>\n\n\n<li><a href=\"https:\/\/pabau.com\/procedure-codes\/cpt-code-72148\/\">CPT code 72148 \u2014 MRI Lumbar Spine Without Contrast<\/a><\/li>\n\n\n<li><a href=\"https:\/\/pabau.com\/procedure-codes\/cpt-code-73221\/\">CPT code 73221 \u2014 MRI Upper Extremity Joint Without Contrast<\/a><\/li>\n<\/ul>\n\n\n\n<h2 id=\"h-how-pabau-supports-ldct-lung-cancer-screening-billing\" class=\"wp-block-heading\">How Pabau supports LDCT lung cancer screening billing<\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">Billing CPT Code 71271 accurately requires managing several interdependent steps: confirming eligibility before the scan, tracking G0296 completion status, pairing the right ICD-10 codes, and ensuring the documentation package is complete before claim transmission. A disorganized workflow at any of these points generates denials.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Pabau&#8217;s claims management tools help practices build pre-submission checklists tied to specific procedure codes, so the billing team can see at a glance whether all required elements are in place before a 71271 claim goes out.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Digital intake forms can capture smoking history, pack-year calculations, and symptom status at the point of scheduling, feeding directly into the patient record rather than requiring manual re-entry at the billing stage.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Practices running preventive screening programs also benefit from Pabau&#8217;s automated recall workflows, which can flag patients due for their annual LDCT renewal and prompt the scheduling team before a screening opportunity is lost.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">For practices focused on keeping patient data secure through the billing process, Pabau&#8217;s HIPAA-aligned architecture supports the documentation standards CMS expects for preventive service claims.<\/p>\n\n\n\n<figure class=\"wp-block-image size-large\"><img decoding=\"async\" src=\"https:\/\/cdn.pabau.com\/cdn\/attachments\/pulse\/content-engine\/billing_codes\/cpt-code-71271\/appointment-scheduling-in-pabau.webp\" alt=\"Appointment scheduling in Pabau\"\/><figcaption class=\"wp-element-caption\"><em>Appointment scheduling in Pabau<\/em><\/figcaption><\/figure>\n\n\n\n<div style=\"height:20px\" aria-hidden=\"true\" class=\"wp-block-spacer\"><\/div>\n\n\n\n<p class=\"wp-block-paragraph\">The result: fewer denied claims, faster reimbursement, and a cleaner audit trail for every CPT Code 71271 submission.<\/p>\n\n\n        <div id=\"pro_tip\">\n            <div class=\"img\">\n                <svg width=\"42\" height=\"42\" viewBox=\"0 0 42 42\" fill=\"none\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\">\n                    <path fill-rule=\"evenodd\" clip-rule=\"evenodd\"\n                        d=\"M12.6383 19.5238C12.6632 21.2071 12.8734 22.9926 12.0685 24.5523C11.0341 26.8917 8.45076 28.169 7.56292 30.5918C6.63082 33.1061 7.19505 36.185 9.31371 37.9786C10.929 39.5678 13.4183 39.9873 15.6061 39.5463C17.4592 39.073 19.1049 37.8388 19.9706 36.1608C20.781 34.7141 20.7866 32.9904 20.5293 31.3985C20.1006 29.3092 18.3775 27.8705 16.9807 26.362C14.8814 24.1005 14.6684 20.6854 15.595 17.8915C16.4331 15.4768 19.0026 14.2344 20.0425 11.9461C20.7202 10.6769 20.7506 9.20327 20.6068 7.81304C20.1864 5.40098 18.3139 3.23631 15.8716 2.56674C13.9742 2.03969 11.8224 2.30052 10.1739 3.37614C8.70522 4.34688 7.5878 5.86618 7.28356 7.58178C6.76081 9.82981 7.53525 12.2822 9.20307 13.9118C10.7658 15.4741 12.4806 17.2273 12.6383 19.5238Z\"\n                        fill=\"#2BADD4\" \/>\n                    <path fill-rule=\"evenodd\" clip-rule=\"evenodd\"\n                        d=\"M22.7048 19.8387C22.6822 22.3279 24.4507 24.6234 26.7493 25.4682C28.0531 25.961 29.4725 25.9183 30.7989 25.5487C32.0575 24.9955 33.301 24.2237 34.0069 23.0092C34.8384 21.5811 35.2982 19.8286 34.7832 18.2094C34.3611 16.2507 32.8739 14.6541 31.0275 13.9426C28.6736 12.9595 25.8073 13.7942 24.1719 15.7001C23.2022 16.8366 22.6143 18.3326 22.7048 19.8387Z\"\n                        fill=\"#2BADD4\" \/>\n                <\/svg>\n            <\/div>\n            <div class=\"text\">\n                <h3>Pro Tip<\/h3>\n                <p>Run a quarterly audit of your 71271 claims by pulling all denials coded with reason code CO-50 (not medically necessary) or CO-167 (diagnosis not covered). These two denial codes account for most CPT 71271 rejections. For each denied claim, trace back to whether Z12.31 was the primary ICD-10 code and whether G0296 was on file before the screening date.<\/p>\n            <\/div>\n        <\/div>\n    \n\n\n<h2 id=\"h-conclusion\" class=\"wp-block-heading\">Conclusion<\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">CPT Code 71271 is a high-value preventive service code, but its billing requirements leave little room for error. Missing the G0296, pairing the wrong ICD-10, or submitting without verified eligibility documentation all produce the same result: a denied claim and revenue recovery work that could have been avoided.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Pabau&#8217;s digital forms and documentation workflows help practices capture every eligibility criterion at the point of scheduling, not at the billing stage where corrections are expensive. To see how Pabau handles preventive service billing workflows, <a href=\"https:\/\/pabau.com\/book-demo\/\">book a demo<\/a> with the team.<\/p>\n\n\n        <div id=\"expert_picks\">\n            <div class=\"header\">\n                                    <img decoding=\"async\" src=\"https:\/\/pabau.com\/wp-content\/uploads\/2025\/11\/Expert-Picks.svg\" alt=\"Continue your research\" height=\"42\" width=\"42\">\n                                <h3>Continue your research<\/h3>\n            <\/div>\n            <div class=\"content\">\n                                                            <div class=\"item\">\n                            <div>\n                                <svg width=\"20\" height=\"27\" viewBox=\"0 0 20 27\" fill=\"none\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\">\n                                    <path\n                                        d=\"M18.6223 14.3857C19.1246 13.8975 19.1246 13.1045 18.6223 12.6162L12.1938 6.36621C11.6915 5.87793 10.8759 5.87793 10.3737 6.36621C9.87143 6.85449 9.87143 7.64746 10.3737 8.13574L14.6125 12.2529H2.28571C1.57455 12.2529 1 12.8115 1 13.5029C1 14.1943 1.57455 14.7529 2.28571 14.7529H14.6085L10.3777 18.8701C9.87545 19.3584 9.87545 20.1514 10.3777 20.6396C10.8799 21.1279 11.6955 21.1279 12.1978 20.6396L18.6263 14.3896L18.6223 14.3857Z\"\n                                        fill=\"#54B2D3\" \/>\n                                <\/svg>\n                            <\/div>\n                            <p><strong>Curious how another Medicare preventive benefit gets billed?<\/strong> <a href=\"https:\/\/pabau.com\/procedure-codes\/hcpcs-code-g0180\/\">G0180<\/a> covers the physician certification Medicare requires before home health services begin.<\/p>\n                        <\/div>\n                                                                                <div class=\"item\">\n                            <div>\n                                <svg width=\"20\" height=\"27\" viewBox=\"0 0 20 27\" fill=\"none\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\">\n                                    <path\n                                        d=\"M18.6223 14.3857C19.1246 13.8975 19.1246 13.1045 18.6223 12.6162L12.1938 6.36621C11.6915 5.87793 10.8759 5.87793 10.3737 6.36621C9.87143 6.85449 9.87143 7.64746 10.3737 8.13574L14.6125 12.2529H2.28571C1.57455 12.2529 1 12.8115 1 13.5029C1 14.1943 1.57455 14.7529 2.28571 14.7529H14.6085L10.3777 18.8701C9.87545 19.3584 9.87545 20.1514 10.3777 20.6396C10.8799 21.1279 11.6955 21.1279 12.1978 20.6396L18.6263 14.3896L18.6223 14.3857Z\"\n                                        fill=\"#54B2D3\" \/>\n                                <\/svg>\n                            <\/div>\n                            <p><strong>Ordering a diagnostic chest CT after a screening finding?<\/strong> <a href=\"https:\/\/pabau.com\/procedure-codes\/cpt-code-71250\/\">71250<\/a> covers the reimbursement and documentation rules for that follow-up scan.<\/p>\n                        <\/div>\n                                                                                <div class=\"item\">\n                            <div>\n                                <svg width=\"20\" height=\"27\" viewBox=\"0 0 20 27\" fill=\"none\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\">\n                                    <path\n                                        d=\"M18.6223 14.3857C19.1246 13.8975 19.1246 13.1045 18.6223 12.6162L12.1938 6.36621C11.6915 5.87793 10.8759 5.87793 10.3737 6.36621C9.87143 6.85449 9.87143 7.64746 10.3737 8.13574L14.6125 12.2529H2.28571C1.57455 12.2529 1 12.8115 1 13.5029C1 14.1943 1.57455 14.7529 2.28571 14.7529H14.6085L10.3777 18.8701C9.87545 19.3584 9.87545 20.1514 10.3777 20.6396C10.8799 21.1279 11.6955 21.1279 12.1978 20.6396L18.6263 14.3896L18.6223 14.3857Z\"\n                                        fill=\"#54B2D3\" \/>\n                                <\/svg>\n                            <\/div>\n                            <p><strong>Coding another high-volume radiology procedure?<\/strong> <a href=\"https:\/\/pabau.com\/procedure-codes\/cpt-code-76801\/\">76801<\/a> covers billing for first-trimester obstetric ultrasound, with its own documentation rules.<\/p>\n                        <\/div>\n                                                                                <div class=\"item\">\n                            <div>\n                                <svg width=\"20\" height=\"27\" viewBox=\"0 0 20 27\" fill=\"none\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\">\n                                    <path\n                                        d=\"M18.6223 14.3857C19.1246 13.8975 19.1246 13.1045 18.6223 12.6162L12.1938 6.36621C11.6915 5.87793 10.8759 5.87793 10.3737 6.36621C9.87143 6.85449 9.87143 7.64746 10.3737 8.13574L14.6125 12.2529H2.28571C1.57455 12.2529 1 12.8115 1 13.5029C1 14.1943 1.57455 14.7529 2.28571 14.7529H14.6085L10.3777 18.8701C9.87545 19.3584 9.87545 20.1514 10.3777 20.6396C10.8799 21.1279 11.6955 21.1279 12.1978 20.6396L18.6263 14.3896L18.6223 14.3857Z\"\n                                        fill=\"#54B2D3\" \/>\n                                <\/svg>\n                            <\/div>\n                            <p><strong>Billing a different therapy-adjacent Medicare service?<\/strong> <a href=\"https:\/\/pabau.com\/procedure-codes\/hcpcs-code-g0153\/\">G0153<\/a> covers the requirements for speech-language pathology billing.<\/p>\n                        <\/div>\n                                                <\/div>\n        <\/div>\n    \n\n\n<h2 id=\"h-frequently-asked-questions\" class=\"wp-block-heading\">Frequently Asked Questions<\/h2>\n\n\n\n<div class=\"schema-faq wp-block-yoast-faq-block\"><div class=\"schema-faq-section\" id=\"faq-question-1784537622770\"><h3 class=\"schema-faq-question\">What is CPT Code 71271 used for?<\/h3> <p class=\"schema-faq-answer\">CPT Code 71271 is used to bill for low-dose computed tomography (LDCT) of the thorax performed as an annual lung cancer screening for high-risk patients. It is not used for diagnostic CT scans of the chest ordered because a patient has symptoms; those use different codes such as 71250 (without contrast) or 71270 (with and without contrast).<\/p> <\/div> <div class=\"schema-faq-section\" id=\"faq-question-1784537622771\"><h3 class=\"schema-faq-question\">What are the Medicare eligibility criteria for CPT 71271?<\/h3> <p class=\"schema-faq-answer\">Medicare requires five criteria: the patient must be aged 50-77, have a minimum 20 pack-year smoking history, be a current smoker or a former smoker who quit within the past 15 years, be asymptomatic for lung cancer, and have completed a shared decision-making visit (G0296) before their first annual screening. CMS updated the age range from 55-77 to 50-77 in February 2022.<\/p> <\/div> <div class=\"schema-faq-section\" id=\"faq-question-1784537622772\"><h3 class=\"schema-faq-question\">Does CPT 71271 require a shared decision-making visit every year?<\/h3> <p class=\"schema-faq-answer\">No. The G0296 shared decision-making visit is required only before the first annual LDCT screening. Subsequent annual screenings for the same patient do not require a repeat G0296. Billing G0296 every year for the same patient is an error that may trigger a compliance review.<\/p> <\/div> <div class=\"schema-faq-section\" id=\"faq-question-1784537622773\"><h3 class=\"schema-faq-question\">What ICD-10 codes are used with CPT 71271?<\/h3> <p class=\"schema-faq-answer\">Z12.31 (encounter for screening for malignant neoplasm of lung) is the required primary ICD-10 code. Common secondary codes include Z87.891 (personal history of nicotine dependence) for former smokers and F17.210 (nicotine dependence, cigarettes, uncomplicated) for current smokers. Never use a symptom code like R05.9 as the primary diagnosis, as this reclassifies the service from preventive to diagnostic.<\/p> <\/div> <div class=\"schema-faq-section\" id=\"faq-question-1784537622774\"><h3 class=\"schema-faq-question\">What is the Medicare reimbursement rate for CPT 71271?<\/h3> <p class=\"schema-faq-answer\">The Medicare reimbursement rate for CPT Code 71271 varies by setting and geographic locality. National averages based on 2025 CMS Physician Fee Schedule data are approximately $100-$130 in a non-facility setting and $50-$75 for the professional component in a facility setting. Rates update each January; verify current rates using the CMS PFS lookup tool or FastRVU before projecting revenue.<\/p> <\/div> <div class=\"schema-faq-section\" id=\"faq-question-1784537622775\"><h3 class=\"schema-faq-question\">Is CPT 71271 covered by commercial insurance?<\/h3> <p class=\"schema-faq-answer\">Most commercial health plans subject to the ACA must cover CPT 71271 with no patient cost-sharing under ACA Section 2713, which mandates coverage of USPSTF Grade B preventive services. Exceptions include grandfathered plans, self-insured ERISA plans, and short-term health plans. Prior authorization requirements and modifier 33 applicability vary by payer, so verify the plan&#8217;s specific policy before billing.<\/p> <\/div> <\/div>\n","protected":false},"excerpt":{"rendered":"<p>Missed eligibility documentation is the top reason CPT Code 71271 claims get denied. Medicare&#8217;s lung cancer screening benefit has strict requirements: age, smoking history, symptom status, and a completed shared decision-making visit must all be confirmed before you submit. Skip any one of them and the claim comes back unpaid. This reference guide covers what [&hellip;]<\/p>\n","protected":false},"author":77,"featured_media":159094,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"_yoast_wpseo_linkdex":"91","_yoast_wpseo_content_score":"30","_yoast_wpseo_is_cornerstone":"","_yoast_wpseo_keywordsynonyms":"[\"\",\"\",\"\",\"\",\"\"]","_yoast_wpseo_focuskw_text_input":"","_seo_original_html":"","footnotes":""},"categories":[1433,1546],"tags":[1364,1439,4126,1162,1163,2385,1236,1713],"class_list":["post-159095","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-billing-codes","category-cpt-codes","tag-billing","tag-claims-management","tag-cpt","tag-cpt-codes","tag-medical-billing","tag-medicare-coverage","tag-medicare-reimbursement","tag-radiology-billing"],"yoast_head":"<!-- This site is optimized with the Yoast SEO Premium plugin v28.2 (Yoast SEO v28.2) - 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