Radiology Coding Alert

CTA codes get a 2008 facelift aimed to bolster your right to report CTAs without modifier 52.

The lowdown: The phrase "without contrast material(s), followed by contrast material(s) and further sections" in CTA codes led many auditors to claim that if the physician didn't perform imaging without contrast, coders had to append modifier 52 (Reduced services) to the CTA code.

But the codes' original intent was to include non-contrast imaging when performed -- not to require it, said William T. Thorwarth Jr., MD, FACR, RCC, chairman of the CPT Editorial Panel, at the CPT and RBRVS 2008 Annual Symposium. (Find the slides for his presentation "CPT 2008 Coding Changes" and other presentations at http://www.ama-assn.org/ama/noindex/category/18175.html.)

The revision will clarify that you can report these CTA codes even without documentation of non-contrast imaging, Thorwarth said. These are the revised CTA codes:

• 70496 -- Computed tomographic angiography, head, with contrast material(s), including noncontrast images, if performed, and image postprocessing

• 70498 -- Computed tomographic angiography, neck, with contrast material(s), including noncontrast images, if performed, and image postprocessing

• 71275 -- Computed tomographic angiography, chest (noncoronary), with contrast material(s), including noncontrast images, if performed, and image postprocessing

• 72191-- Computed tomographic angiography, pelvis, with contrast material(s), including noncontrast images, if performed, and image postprocessing

• 73706 -- Computed tomographic angiography, lower extremity, with contrast material(s), including noncontrast images, if performed, and image postprocessing

• 74175-- Computed tomographic angiography, abdomen, with contrast material(s), including noncontrast images, if performed, and image postprocessing

• 75635-- Computed tomographic angiography, abdominal aorta and bilateral iliofemoral lower extremity runoff, with contrast material(s), including noncontrast images, if performed, and image postprocessing.

CPT 2008 made the same revisions to the cardiac CTA codes 0145T-0151T, changing the initial portion of each descriptor to: Computed tomography, heart, with contrast material(s), including noncontrast images, if performed, cardiac gating and 3D image postprocessing.