How To Use CPT Code 74018

CPT 74018 refers to a radiologic examination of the abdomen with one view, and this article will cover its description, procedure, qualifying circumstances, usage, documentation requirements, billing guidelines, historical information, similar codes, and examples.

1. What is CPT 74018?

CPT 74018 is a medical billing code used to describe a radiologic examination of the abdomen with one view. This code is utilized by medical coders and billers to report the specific service provided to a patient during a diagnostic imaging procedure. The examination is performed to diagnose certain abdominal problems and assess the structures and organs within the abdomen, such as the stomach, liver, spleen, large and small intestines, and diaphragm.

2. 74018 CPT code description

The official description of CPT code 74018 is: “Radiologic examination, abdomen; 1 view.”

3. Procedure

  1. The patient is positioned either in a standing or lying position, depending on the provider’s preference and the patient’s condition.
  2. If standing, the patient steps behind a wall where the X-ray machine is kept and stands straight in front of the machine.
  3. If lying down, the patient lies on a bed, and the X-ray machine is positioned over the abdomen.
  4. The provider instructs the patient to hold their breath and stay still for 2 to 3 seconds while the X-ray pictures are taken to prevent blurring of the image.

4. Qualifying circumstances

Patients eligible to receive CPT code 74018 services are those who require a diagnostic imaging procedure to assess the structures and organs within the abdomen. This may include patients experiencing abdominal pain, suspected gastrointestinal obstruction, or other abdominal issues that warrant further investigation. The provider must determine the medical necessity of the examination and ensure that the patient’s condition warrants the use of this specific code.

5. When to use CPT code 74018

CPT code 74018 should be used when a single view of the abdomen is performed to diagnose certain abdominal problems. This code is appropriate for cases where only one view is necessary to obtain the required diagnostic information. The provider must ensure that the patient’s condition warrants the use of this specific code and that the examination is medically necessary.

6. Documentation requirements

To support a claim for CPT 74018, the provider’s documentation should include:

  • A clear description of the patient’s presenting symptoms and medical history that justify the need for the examination.
  • A detailed account of the examination procedure, including the patient’s body position and the projection of the X-ray.
  • A thorough interpretation of the X-ray findings, including any abnormalities or issues identified.
  • A diagnosis or clinical impression based on the examination results.
  • Any recommendations for further testing or treatment, if applicable.

7. Billing guidelines

When billing for CPT code 74018, keep the following guidelines in mind:

  • For two views of the abdomen, report CPT code 74019, and for three or more views, report CPT code 74021.
  • Ensure that the provider’s documentation clearly describes each view taken in the radiology service and the patient’s body position and projection of the X-ray to assign the correct number of views.
  • If reporting only the physician’s interpretation for the radiology service, append professional component modifier 26 to the radiology code.
  • If reporting only the technical component for the radiology service, append modifier TC to the radiology code. Note that payer policy may exempt hospitals from appending modifier TC because the hospital’s portion is inherently technical.
  • Do not append a professional or technical modifier to the radiology code when reporting a global service in which one provider renders both the professional and technical components.

8. Historical information

CPT 74018 was added to the Current Procedural Terminology system on January 1, 2018. There have been no updates to the code since its addition.

9. Similar codes to CPT 74018

Five similar codes to CPT 74018 and how they differentiate are:

  • CPT 74019: This code is used for radiologic examinations of the abdomen with two views, as opposed to the single view in CPT 74018.
  • CPT 74021: This code is used for radiologic examinations of the abdomen with three or more views, providing a more comprehensive assessment than CPT 74018.
  • CPT 74022: This code is used for a combination of radiologic examinations, including the abdomen, chest, and pelvis, offering a broader scope than CPT 74018.
  • CPT 76700: This code is used for an ultrasound examination of the abdomen, which is a different imaging modality than the X-ray used in CPT 74018.
  • CPT 74150: This code is used for a computed tomography (CT) scan of the abdomen without contrast material, which is a more advanced imaging technique than the X-ray in CPT 74018.

10. Examples

Here are ten detailed examples of CPT code 74018 procedures:

  1. A patient presents with acute abdominal pain, and the provider orders a single view X-ray of the abdomen to rule out bowel obstruction.
  2. A patient with a history of kidney stones experiences sudden onset flank pain, and the provider orders a single view X-ray of the abdomen to check for the presence of stones.
  3. A patient with suspected gastrointestinal bleeding undergoes a single view X-ray of the abdomen to identify any abnormalities in the gastrointestinal tract.
  4. A patient with a history of liver disease presents with worsening jaundice, and the provider orders a single view X-ray of the abdomen to assess the liver’s size and shape.
  5. A patient with a suspected abdominal mass undergoes a single view X-ray of the abdomen to determine the location and size of the mass.
  6. A patient with a history of abdominal surgery presents with new-onset abdominal pain, and the provider orders a single view X-ray of the abdomen to check for postoperative complications.
  7. A patient with suspected appendicitis undergoes a single view X-ray of the abdomen to assess the appendix and surrounding structures.
  8. A patient with a known abdominal aortic aneurysm undergoes a single view X-ray of the abdomen to monitor the aneurysm’s size and stability.
  9. A patient with a history of Crohn’s disease presents with worsening abdominal pain, and the provider orders a single view X-ray of the abdomen to assess the extent of bowel inflammation.
  10. A patient with a suspected inguinal hernia undergoes a single view X-ray of the abdomen to confirm the diagnosis and determine the severity of the hernia.

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