Radiology Coding Alert

Reader Question:

Eat the Cost of Oral Contrast

Question: We often perform CT abdominal scans following oral contrast, but without IV contrast. We don't charge for the oral contrast, but we'd like to start billing for it. Which CPT code should we report for the oral contrast administration?

Connecticut Subscriber
 
Answer: Unfortunately, you cannot bill your insurer for oral contrast. The introduction to CPT's radiology section states, "The phrase 'with contrast'... represents contrast material administered intravascularly, intra-articularly or intrathecally .... Oral and/or rectal contrast administration alone does not qualify as a study 'with contrast.' "
 
You should only report the contrast administration codes if you administer it using one of the three methods that CPT advises. Oral and rectal contrast administration reimbursement is included in the code for the scan itself.