How To Use CPT Code 74174

CPT 74174 refers to computed tomographic angiography of the abdomen and pelvis with contrast material(s), including noncontrast images, if performed, and image postprocessing. This article will cover the description, procedure, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information, similar codes, and examples of CPT 74174 procedures.

1. What is CPT 74174?

CPT 74174 is a medical billing code used to describe a specific type of diagnostic imaging procedure, which involves computed tomographic angiography (CTA) of the abdomen and pelvis with the use of contrast material(s). This code is used by medical coders and billers to accurately report and bill for this procedure when performed by healthcare providers.

2. 74174 CPT code description

The official description of CPT code 74174 is: “Computed tomographic angiography, abdomen and pelvis, with contrast material(s), including noncontrast images, if performed, and image postprocessing.”

3. Procedure

1. The patient is placed in a supine position on the CT scanner table.
2. An intravenous (IV) line is inserted into the patient’s arm or hand.
3. The provider supervises the placement of the IV, administration of contrast, scout films or preliminary images, and the actual abdomen and pelvis image acquisition.
4. A radiologic agent or dye is used as the contrast material, which is injected through the small catheter placed in the patient’s vein.
5. The CT scanner moves around the patient’s body, taking images of the abdomen and pelvis.
6. The images are displayed on a monitor screen for the radiology provider to review and analyze.
7. The provider performs a diagnostic interpretation of the results and prepares a written report of their findings.
8. Postprocessing image reconstruction is performed by the technician under the provider’s supervision.

4. Qualifying circumstances

Patients who are eligible to receive CPT code 74174 services are those who require diagnostic imaging of their abdomen and pelvis blood vessels for the purpose of diagnosing, managing, or treating diseases such as aneurysms or blood clots. The procedure must involve the use of contrast material(s) and may include noncontrast images if performed. Additionally, image postprocessing must be included in the service.

5. When to use CPT code 74174

It is appropriate to bill the 74174 CPT code when the provider performs computed tomographic angiography of the abdomen and pelvis with contrast material(s), including noncontrast images, if performed, and image postprocessing. This code should only be used if the CTA of the abdomen occurs during the same session as the CTA of the pelvis. If the provider performs these two services independently, CPT 74175 should be used for the abdomen and CPT 72191 for the pelvis imaging.

6. Documentation requirements

To support a claim for CPT 74174, the following information should be documented:

• Patient’s medical history and reason for the procedure
• Details of the procedure, including the use of contrast material(s) and any noncontrast images taken
• Image postprocessing performed by the technician
• Diagnostic interpretation of the results by the provider
• Written report of the provider’s findings

7. Billing guidelines

When billing for CPT code 74174, keep in mind the following guidelines and rules:

• 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.
• Do not report CPT 74174 in conjunction with CPT 72191, 73706, 74175, 75635, 76376, or 76377. For CTA aorto-iliofemoral runoff, use CPT 75635.

8. Historical information

CPT 74174 was added to the Current Procedural Terminology system on January 1, 2012. There have been no updates to the code since its addition.

9. Similar codes to CPT 74174

Five similar codes to CPT 74174 and how they differentiate from CPT 74174 are:

• CPT 74175: This code is used for CTA of the abdomen only, not including the pelvis.
• CPT 72191: This code is used for CTA of the pelvis only, not including the abdomen.
• CPT 73706: This code is used for CTA of the lower extremity, not involving the abdomen or pelvis.
• CPT 75635: This code is used for CTA aorto-iliofemoral runoff, which is a more specific type of imaging involving the aorta and iliofemoral arteries.
• CPT 76376: This code is used for 3D rendering with the interpretation and reporting of computed tomography, which is a different type of image postprocessing.

10. Examples

Here are 10 detailed examples of CPT code 74174 procedures:

1. A patient with a suspected abdominal aortic aneurysm undergoes CTA of the abdomen and pelvis with contrast material and image postprocessing.
2. A patient with a history of deep vein thrombosis requires CTA of the abdomen and pelvis to evaluate for possible blood clots.
3. A patient with unexplained abdominal pain undergoes CTA of the abdomen and pelvis with contrast material to rule out vascular abnormalities.
4. A patient with a known pelvic mass requires CTA of the abdomen and pelvis with contrast material to assess the blood supply to the mass.
5. A patient with a history of vascular disease undergoes CTA of the abdomen and pelvis with contrast material for routine monitoring.
6. A patient with suspected mesenteric ischemia undergoes CTA of the abdomen and pelvis with contrast material to evaluate blood flow to the intestines.
7. A patient with a history of renal artery stenosis requires CTA of the abdomen and pelvis with contrast material to assess the blood flow to the kidneys.
8. A patient with a suspected iliac artery aneurysm undergoes CTA of the abdomen and pelvis with contrast material and image postprocessing.
9. A patient with a history of peripheral artery disease requires CTA of the abdomen and pelvis with contrast material to evaluate blood flow to the lower extremities.
10. A patient with a known abdominal tumor undergoes CTA of the abdomen and pelvis with contrast material to assess the blood supply to the tumor and plan for surgical intervention.