Radiology Coding Alert

Question: When the report shows an abdominal CT using oral contrast followed by abdominal CT using IV contrast, should I report 74160 or 74170?

Louisiana Subscriber

Answer: You should report 74170 (Computed tomography, abdomen; without contrast material, followed by contrast material[s] and further sections) when the patient has imaging using oral contrast followed by imaging using intravenous (IV) contrast.

Reason: CPT's radiology guidelines indicate that "with contrast" codes apply only for intravascular, intraarticular, or intrathecal contrast. The oral contrast alone therefore is the same as "without contrast" when choosing your code.

Note that if the patient had only one set of abdominal CT images performed and used both oral and IV contrast, you should report 74160 (... with contrast material[s])instead of 74170 because the radiologist did not interpret a separate set of "without contrast" images.