CT SCAN AND CTA CPT codes list 74174

CT and CTA's Procedure Code 
CT abdomen and pelvis w/o contrast; renal stone 74176
CT abdomen and pelvis; with contrast i.e. enterography 74177
CT abdomen and pelvis; w/o contrast followed by with contrast 74178
CT abdomen w/o followed by contrast 74170
CT abdomen; w/o contrast 74150
CT abdomen; with contrast 74160
CT ablation renal radiofrequency 50592
CT cervical spine; w/o contrast 72125
CT cervical spine; w/o contrast followed by with contrast 72127
CT cervical spine; with contrast 72126
CT chest (thorax) w/o contrast followed by contrast 71270
CT chest (thorax) w/o contrast - high resolution - limited 71250
CT chest (thorax) with contrast, chest tube placement 71260
CT CTA Abdomen/Pelvis Panel 74174
CT CTA Abdomen/Pelvis Panel; two separate   orders/codes 71275, 74174 
CT CTA Chest/Abdomen Panel; two separate orders/codes 71275, 74175 
CT head or brain; w/o contrast, stroke protocol 70450
CT head or brain; w/o contrast followed by with contrast 70470
CT head or brain; with contrast 70460
CT heart score 76380
CT heart; w/o contrast, calcium scoring 75571
CT lower extremity; w/o contrast 73700
CT lower extremity; w/o contrast followed by contrast 73702
CT lower extremity; with contrast 73701
CPT Code Tool 
CT lumbar spine; w/o contrast 72131
CT lumbar spine; w/o contrast followed by with contrast 72133
CT lumbar spine; with contrast 72132
CT maxillofacial area limited w/o contrast, sinus 70486
CT maxillofacial area; w/o contrast followed by with contrast 70488
CT maxillofacial area; with contrast 70487
CT maxillofacial area; w/o contrast 70486
CT neck soft tissue w/o contrast 70490
CT neck soft tissue with contrast 70491
CT orbit; sella or posterior fossa; w/o contrast 70480
CT orbit; sella or posterior fossa; w/o contrast followed by with contrast 70482
CT orbit; sella or posterior fossa; with contrast 70481
CT pelvis; w/o contrast 72192
CT pelvis; w/o contrast followed by with contrast 72194
CT pelvis; with contrast 72193
CT soft tissue neck; w/o contrast 70490
CT soft tissue neck; w/o contrast followed by with contrast 70492
CT soft tissue neck; with contrast 70491
CT thoracic spine; w/o contrast 72128
CT thoracic spine; w/o contrast followed by with contrast 72130
CT thoracic spine; with contrast 72129
CT upper extremity; w/o contrast 73200
CT upper extremity; w/o contrast followed by contrast 73202
CT urogram 74178
CT upper extremity; with contrast 73201
CTA abdomen; w/o contrast followed by contrast and further sections 74175
CTA chest no coronary 71275
CPT Code Tool 
CTA head and neck (order separately) 70496, 70498 
CTA head; w/o contrast followed by with contrast 70496
CTA heart coronary arteries and cardiac structure 75574
CTA lower extremity 73706
CTA neck; w/o contrast followed by with contrast 70498
CTA pelvis; w/o contrast followed by with contrast 72191
CTA runoff AAA bilateral lower extremity 75635
CTA upper extremity 73206


Abdomen CT and Pelvis CT

Prior to 2011, computed tomography (CT) of the abdomen and CT of the pelvis could be reported, and were reimbursed, separately. CPT® 2011 created new codes (e.g., 74174 Computed tomography, abdomen and pelvis; without  contrast material, 74177 Computed tomography, abdomen and pelvis; with contrast, and 74178 Computed tomography, abdomen and pelvis; without contrast material in 1 or  both body regions, followed by contrast material(s) and further sections in 1 or both body regions) that bundle the procedures when performed together.


Such bundling has a significant financial impact. For example, per the 2012 Centers for Medicare & Medicaid Services (CMS) Physician Fee Schedule Relative Value File, CT of the abdomen with contrast (74160 Computed tomography, abdomen; with contrast material(s)) is valued at 1.27 work relative value units (RVUs), while CT of the pelvis with contrast (72193 Computed tomography, pelvis; with contrast material(s)) is 1.16 RVUs.If reported separately, these codes total 2.43 RVUs. But when these procedures are bundled into the single code 74177 (as they have been since Jan. 1, 2011), the work RVUs are 1.82, or approximately 25 percent lower.


Advanced Radiology including PET scans, CT Scans, MRI’s require authorization inclusive of the following codes:

- PET Scans (78459, 78491, 78492, 78608, 78609, 78811 to 78816)
- Breast MRI’s (77058 through 77059)
- CT Cardiology studies (75571 through 75574)
- GI Endoscopy – 45378 effective February 1, 2016
- Injection procedure for shoulder arthrography/enhanced CT/MRI shoulder arthrography (23350) effective February 1, 2016
- All of the following radiology/imaging codes are effective February 1, 2016: 70460, 70470, 70481, 70482, 70486-70492, 70496, 70498, 70540, 70551-70553, 71250, 71260, 71270, 71275, 71550-71552, 72126, 72127, 72129, 72130, 72132, 72133, 72156-72158, 72192-72194, 72291, 72292, 73200-73202, 73218-73223, 73225, 73700-73702, 74150, 74160, 74170, 74174-74176, 74178, 74179, 75557, 75559, 75561, 75563, 75565, 76120, 76125, 77011-77013, 77021, 77022, 77084, 78226, 78227, 78350, 78351, 78445, 78451-78454, 

GI Radiology services including 91110, 91111

Authorization for High-tech Imaging Services

Blue Cross and HMO Louisiana are contracted with AIM Specialty Health (AIM), an independent company, to administer authorization services for select elective outpatient high-tech imaging studies. All authorization requests should be made through iLinkBLUE using the ProviderPortalSM. Ordering physicians must contact AIM directly for authorization of the services mentioned in this section for Blue Cross, HMO Louisiana and Federal Employee Program (FEP) members. AIM conducts authorization services for the following outpatient, non-emergent imaging services for Blue Cross and HMO Louisiana:

• Computerized Tomography (CT) Scans

• Computerized Tomography Angiography (CTA)

• Magnetic Resonance Imaging (MRI) – excluding Procedure  70336 as these authorizations are handled directly by Blue Cross. Most Blue Cross member contracts do not cover this service; however, a few large employers do provide some level of coverage.

• Magnetic Resonance Angiography (MRA)

• Nuclear Cardiology Procedures

• Positron-Emission Tomography (PET) Scans

Please note: imaging studies performed in conjunction with emergency room services, inpatient hospitalization, outpatient surgery (hospitals and freestanding surgery centers) or 23-hour observations are not included in this radiology program.

Ordering physicians (whether a primary care physician (PCP) or specialist) are required to provide AIM with basic clinical information and patient demographics to obtain the authorization. The PCP will not be expected to obtain the authorization number if a specialist orders the test. Hospitals and freestanding facilities that perform the technical component of the imaging services cannot obtain an authorization number and should not obtain authorizations for ordering physicians; however, they may check the status of an authorization request through iLinkBLUE.

Blue Cross implements a full utilization review program in which all clinical information provided by the ordering physician will be reviewed against AIM’s clinical guidelines for medical necessity. If a request for authorization is denied, AIM notifies the ordering physician of the denial and the process for appeals. Reconsiderations and first-level appeals on authorizations denied for medical necessity should be sent directly to AIM. First-level appeals on authorizations denied as experimental/investigational should be sent directly to Blue Cross. Please allow ample time in scheduling diagnostic services to insure the authorization process is completed and approved before the patient receives services. Ordering physicians should contact AIM to obtain authorization in one of two ways:

1. Use iLinkBLUE Provider Suite to access AIM’s web-based application, ProviderPortalSM. Ordering physicians can easily enter authorization requests and get immediate response for most requests.

Additionally, both ordering and performing providers can check authorization status and view authorization numbers using the  providerPortalSM.

2. Contact AIM directly by calling 1-866-455-8416.

1 comment:

  1. Can a MIP be used instead of a 3D during a CTA Chest for PE

    ReplyDelete

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