Radiology Coding Alert

Question: I’m new to radiology coding, and I have an op note documenting a CT cystogram with contrast. I’m trying to find the correct codes to use, and 74430 is listed in CPT^® for a cystography but 72193 reflects a CT scan of the pelvis with contrast.

Could you please guide me through reporting this procedure?

Arkansas Subscriber

Answer: Accurately coding a CT cystogram requires multiple codes to ensure reimbursement. Ideally, you should code for the administration of the contrast followed by the computed tomography (CT) scan.

For your situation, your first CPT^® code will be 51600 (Injection procedure for cystography or voiding urethrocystography) to document the insertion of the urinary catheter through the urethra into the bladder followed by the contrast material injection.

Then, according to the information you’ve provided, you will use 74430 (Cystography, minimum of 3 views, radiological supervision and interpretation) to document the cystography procedure. Lastly, you’ll code 72193 (Computed tomography, pelvis; with contrast material(s)) for the CT scan with contrast.

Some providers may try to bill with 51600 and 72194 (Computed tomography, pelvis; without contrast material, followed by contrast material(s) and further sections), but 72194 is for intravenous (IV) or injection contrast only.