Radiology Coding Alert

Question: Our facility recently purchased a new CT machine. We now perform a pelvic and abdominal CT without and with contrast. Then we perform a post-void x-ray. We also perform coronal reconstruction. How should we code this?

Tennessee Subscriber

Answer: You should report the abdominal CTs using 74170 (Computed tomography, abdomen; without contrast material, followed by contrast material[s] and further sections). Report 72194 (Computed tomography, pelvis; without contrast material, followed by contrast material[s] and further sections) for the pelvic CTs.

Ideal: Help auditors credit your radiologist for his work by suggesting he discuss the state of the abdominal structures in one paragraph and the state of the pelvic structures in another.

The appropriate code for a single post-void abdominal x-ray is 74000 (Radiologic examination, abdomen; single anteroposterior view). Correct Coding Initiative edits don't bundle this x-ray code with the CT codes, so you should be able to report it separately. Just be sure the radiologist documents medical necessity for the exam.

Caution: You shouldn't report the coronal reconstruction -- which is 2D -- separately. Codes 76376 and 76377 (3D rendering with interpretation and reporting of computed tomography, magnetic resonance imaging, ultrasound, or other tomographic modality ...) are for 3D reconstruction only.