How To Use CPT Code 74160

CPT 74160 refers to a computed tomography (CT) scan of the abdomen with the use of contrast material(s). This article will cover the description, procedure, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information, similar codes, and examples of CPT code 74160 procedures.

1. What is CPT 74160?

CPT 74160 is a medical billing code used to describe a computed tomography (CT) scan of the abdomen with the use of contrast material(s). This diagnostic imaging procedure is performed to create cross-sectional images of the abdomen, which can aid in the diagnosis and treatment of various abdominal conditions. The use of contrast material enhances the images, providing more detailed information for the healthcare provider.

2. 74160 CPT code description

The official description of CPT code 74160 is: “Computed tomography, abdomen; with contrast material(s)”.

3. Procedure

The 74160 procedure involves the following steps:

1. The patient is appropriately prepped and positioned on the CT scanner table.
2. Contrast material is injected into the patient’s bloodstream, usually through an intravenous (IV) line.
3. The CT scanner takes multiple cross-sectional images of the abdomen as the patient moves through the scanner.
4. The images are displayed on a monitor screen and analyzed by a radiology provider.
5. A radiologic technician typically performs the procedure, while a radiology provider interprets the data and provides analysis.

4. Qualifying circumstances

Patients who are eligible to receive CPT code 74160 services include those with suspected or confirmed abdominal conditions that require further diagnostic evaluation. Examples of such conditions may include, but are not limited to, abdominal pain, masses, infections, inflammation, or suspected malignancies. The use of contrast material in the CT scan can help to better visualize blood vessels, organs, and other structures within the abdomen, providing more accurate diagnostic information for the healthcare provider.

5. When to use CPT code 74160

CPT code 74160 should be used when a healthcare provider orders a CT scan of the abdomen with contrast material(s) for diagnostic purposes. This code is appropriate for billing when the procedure is performed to evaluate a patient’s abdominal condition and the use of contrast material is deemed necessary to obtain the most accurate and detailed images possible.

6. Documentation requirements

Documentation supporting a claim for CPT 74160 should include the following information:

• A detailed medical history and physical examination of the patient.
• A clear indication of the medical necessity for the CT scan with contrast material(s).
• A description of the patient’s symptoms or clinical findings that warrant the use of contrast material in the CT scan.
• Documentation of the informed consent obtained from the patient for the procedure, including the risks and benefits of using contrast material.
• A detailed report of the CT scan findings, including any abnormalities or relevant findings that may impact the patient’s diagnosis or treatment plan.

7. Billing guidelines

When billing for CPT code 74160, it is important to follow the appropriate guidelines and rules. Some tips and codes that apply to CPT code 74160 include:

• For CT abdomen without contrast, report CPT 74150.
• For CT abdomen first without contrast followed by contrast and additional sections, report CPT 74170.
• 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 74160 was added to the Current Procedural Terminology system on January 1, 1990. The code was changed on January 1, 2003, from its previous descriptor, “Computerized axial tomography, abdomen; with contrast material(s)”.

9. Similar codes to CPT 74160

Five similar codes to CPT 74160 and how they differentiate from CPT 74160 are:

1. CPT 74150: This code is used for CT scans of the abdomen without the use of contrast material(s).
2. CPT 74170: This code is used for CT scans of the abdomen that are first performed without contrast, followed by the administration of contrast material and additional sections.
3. CPT 74176: This code is used for CT scans of the abdomen and pelvis with contrast material(s).
4. CPT 74177: This code is used for CT scans of the abdomen and pelvis without contrast, followed by contrast material and additional sections.
5. CPT 74178: This code is used for CT scans of the abdomen and pelvis without contrast, followed by contrast material and further delayed sections.

10. Examples

Here are 10 detailed examples of CPT code 74160 procedures:

1. A patient with a history of abdominal pain and weight loss undergoes a CT scan of the abdomen with contrast to evaluate for possible malignancy.
2. A patient with a suspected abdominal aortic aneurysm undergoes a CT scan of the abdomen with contrast to assess the size and extent of the aneurysm.
3. A patient with a history of inflammatory bowel disease undergoes a CT scan of the abdomen with contrast to evaluate the extent of bowel inflammation and complications such as abscesses or fistulas.
4. A patient with a suspected liver mass undergoes a CT scan of the abdomen with contrast to characterize the lesion and determine its relationship to surrounding structures.
5. A patient with a history of pancreatitis undergoes a CT scan of the abdomen with contrast to assess for complications such as pseudocysts or abscesses.
6. A patient with a suspected renal mass undergoes a CT scan of the abdomen with contrast to evaluate the size, location, and characteristics of the mass.
7. A patient with a history of abdominal trauma undergoes a CT scan of the abdomen with contrast to assess for injuries to abdominal organs and blood vessels.
8. A patient with a suspected gastrointestinal bleed undergoes a CT scan of the abdomen with contrast to identify the source of bleeding and guide further management.
9. A patient with a history of abdominal pain and fever undergoes a CT scan of the abdomen with contrast to evaluate for possible intra-abdominal infection or abscess.
10. A patient with a suspected abdominal hernia undergoes a CT scan of the abdomen with contrast to assess the size and location of the hernia and determine the need for surgical intervention.