Radiology Coding Alert

Question: If the radiologist documents "IV bolus study of the abdomen and pelvis with delayed images" for CTs, does "delayed images" mean without and with contrast?

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Answer: This documentation reflects studies with contrast only.

That means you should report 72193 (Computed tomography, pelvis; with contrast material[s]) and 74160 (Computed tomography abdomen; with contrast material[s]).

IV bolus: The documentation notes administration of "IV bolus." That indicates the patient received contrast intravenously. CPT guidelines state that intravascular contrast qualifies for codes that specify "with contrast." (CPT states oral and rectal contrast don't qualify for "with contrast" codes.)

Delayed images: "Delayed images" in this scenario often indicates the provider rescanned the patient after allowing enough time for the contrast to enter the bladder. You should not report this differently than a typical abdomen/pelvis CT.

Watch for: If the radiologist had documented also reading images taken before contrast administration, then you could report the appropriate without and with contrast CT codes.