Radiology Coding Alert

Question: I have a procedure note where the radiologist performed a computed tomography (CT) scan of the patient’s abdomen with intravascular (IV) contrast. Should I use a “with contrast” CT code?

Minnesota Subscriber

Answer: Yes, you will assign a “with contrast” CT code for the procedure. In this case, 74160 (Computed tomography, abdomen; with contrast material(s)) is the correct code to use.

According to the CPT^® Radiology guidelines, “The phrase ‘with contrast’ used in the codes for procedures performed using contrast for imaging enhancement represents contrast material administered intravascularly, intra-articularly, or intrathecally.” The guidelines continue to instruct that contrast administered orally or rectally does not count as an exam performed “with contrast.”

The CPT^® guidelines also state that IV contrast material applies to the following “with contrast” procedures:

• CT
• Computed tomographic angiography (CTA)
• Magnetic resonance imaging (MRI)
• Magnetic resonance angiography (MRA)

If the provider performed a CT of the abdomen with oral contrast, then you’d assign 74150 (… without contrast material).