CPT Codes for CT Abdomen and Pelvis with Contrast – Overview
What is a CT scan?
CT (Computed tomography) is a diagnostic technique that uses X-rays to produce a 3D image of a body cross-section. It creates a scan that views soft tissues and bones in detail by displaying very thin slices of bones, viscera, muscles, and blood vessels. Unlike x-ray machines that point X-rays at a single spot while producing 2D images, CT scans are made by rotating the X-ray beam 360 degrees around the body and capturing a detailed 3D view.
In medical coding and billing, every radiological procedure, like CT scan, MRI, etc., has its different procedure code (CPT code) according to the regions of the body and injectable materials (contrast).
What is a CT scan with contrast?
A CT Scan that uses a contrast agent like a dye to highlight certain features in the images is called a contrast CT scan. It improves the quality of the images and reduces the distortion probability.
CPT codes for CT scan:
CPT codes help document the diagnostic evaluation performed by a Computerized Tomography scanner of the body and organs. These codes are reported to show the required evaluation method and the reason for prescribing that method. These codes also differentiate CT scans from other radiological evaluations or services.
CPT codes for CT scanning of the abdomen and pelvis change according to the contrast being used and scanning of regions or sections of the abdomen and pelvis.
The following CPT codes describe the CT imaging of the abdomen and pelvis:
Description: Computed tomography; abdomen and pelvis; without contrast materials
This code is reported when the same session scans the abdomen and pelvis without contrast.
Description: Computed tomography; abdomen and pelvis; with contrast materials.
This code is reported when the abdomen and pelvis are scared using contrast material in the same session.
Description: Computed tomography; abdomen and pelvis; without contrast material in one or both body regions (abdomen and pelvis), followed by contrast materials and further sections in one or both body regions
This code is reported when scanning one or both sections is performed using contrast material, followed by scanning other sections without contrast material. It is also reported when one session includes the CT scanning of either abdomen or pelvis without using contrast material, and the second section involves using contrast material.
Other codes for imaging of the abdomen or pelvis:
CPT 74150: This code is reported for computed tomography of the abdomen without using the contrast material.
CPT 74160: This code is used to report the computed tomography session of the abdomen with contrast materials.
CPT 74170: This code is used to report the computed tomography session of the abdomen without using contrast material, followed by another session of computer tomography of the abdomen with contrast material.
CPT 72192: This code is reported for computed tomography of the pelvis without using contrast material.
CPT 72193: This code is used to report the computer tomography session of the pelvis while using contrast material.
CPT 72194: This code is used to report the computed tomography session of the pelvis without using contrast material, followed by another session of computer tomography of the pelvis while using contrast material.
How to bill for a CT scan of the abdomen and pelvis?
The following instructions should be considered before billing the CT scan for the abdomen and pelvis:
- CPT codes 74176, 74177, and 74178 should not be used in conjunction with 72192, 72193, and 72194.
- CPT codes 74176, 74177, and 74178 should not be used in conjunction with 74150, 74160, and 74170.
- Codes 74176, 74177, and 74178 should only be used once per CT scan of the abdomen and pelvis.
Additional note about the use of contrast: The codes reported for using contrast material in CT scanning only describe the procedures that include administering contrast material intravascularly, intraarticularly, and intrathecally. They do not include the oral or rectal administration of contrast. Hence, when a CT scan is performed with oral or rectal administration of contrast but without intravenous administration of contrast, it is reported under CPT code 74176.
When CT abdomen is performed individually or during other nonpelvic studies, stand-alone codes 74150, 74160, and 74170 are reported.
When a CT scan of the pelvis is performed individually or during other non-abdominal studies, stand-alone codes 72192, 72193, and 72194 are reported.
Using a modifier:
Suppose a patient comes to ER and undergoes the CT scan of the abdomen and pelvis without contrast, and for some reason, he goes back for another CT scan of the abdomen and pelvis with contrast on the same day. In that case, a modifier 59 or XU (depending on the payer) will be used to indicate that scans were separate and distinct.
Modifier 59 is also used when, as a result of a combined study of the abdomen and pelvis, a CT scan of the abdomen and pelvis is carried out, and on the same day, an evaluation of either abdomen or pelvis requires an individual CT scan of either the abdomen or pelvis. Modifier 59 should be appended to stand-alone codes for separate CT scans.
Modifiers 26 and TC are used for most radiological diagnostic procedures. Modifier 26 is for the professional component of a service provided by a physician. TC modifier is used when a technical component or part of a service is provided. When the appropriate Medicare Physician Fee Schedule amount for Modifier TC or 26 is not applied, overpayment occurs.
- John Verhovshek, MA, CPC; Radiology Billing and Coding: Coding for CT Imaging of the Abdomen and Pelvis; Radiology Today; 2016.
Jeffery Gordon, RN, MSN, CCA, COC; Coding CT Abdomen and Pelvis Without and With Contrast on the Same Date of Service; Medical Management PlusInc; 2021.
Jitendra M. Sc CPC; CPT Code 74178; When and how to use by coders; American Medical Coding ; 2020.