Billing and Coding: Computed Tomography Cerebral Perfusion Analysis (CTP)

This billing and coding guidance for CT cerebral perfusion analysis complements the LCD: coverage requires documentation of medical necessity consistent with the LCD. Claims must include a valid ICD-10-CM diagnosis (or risk being returned), and when applicable the referring/ordering physician's name and NPI; follow NCCI and OPPS coding edits. Required documentation includes a formal written interpretive report (demographics, interpreting provider, reason, findings), copies of images, and retained image reconstruction data.

"CT cerebral perfusion analysis is covered when the patient's medical record documents medical necessity consistent with the associated Local Coverage Determination (LCD) for CTP."

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