How To Use CPT Code 70492

CPT 70492 describes the diagnostic radiology procedure used to examine the soft tissue structures of the neck. This article will cover the description, procedure, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information, similar codes and billing examples.

1. What is CPT Code 70492?

CPT 70492 is a diagnostic radiology procedure that focuses on imaging the soft tissue structures of the neck. This code is used when a provider uses computed tomography (CT) to obtain cross-sectional images of the neck’s soft tissue structures. The procedure involves taking images without contrast and then administering contrast before taking additional images to enhance visibility.

2. Official Description

The official description of CPT code 70492 is: ‘Computed tomography, soft tissue neck; without contrast material followed by contrast material(s) and further sections.’ This code does not include 3D rendering and should not be used for cervical spine imaging.

3. Procedure

1. The patient is positioned on a table that slides into the CT scanner.
2. The provider uses the CT scanner to take cross-sectional images of the soft tissue structures in the neck.
3. Initial images are taken without administering contrast material.
4. Contrast material is then administered, either orally or intravenously, to enhance visibility.
5. Additional images are taken after the administration of contrast material.
6. A computer generates slices from the obtained images, allowing the provider to identify tumors, abnormalities, and foreign bodies in the soft tissue structures of the neck.

4. Qualifying circumstances

CPT 70492 is used for patients who require imaging of the soft tissue structures in the neck. This procedure is typically performed to diagnose, manage, and treat diseases affecting the neck’s soft tissues. The use of contrast material is necessary to enhance visibility and identify abnormalities. Providers must ensure that the contrast material is administered intravascularly, intraarticularly, or intrathecally to report this code accurately.

5. When to use CPT code 70492

CPT code 70492 should be used when a provider performs a CT scan of the soft tissue structures in the neck without contrast material, followed by the administration of contrast material and further imaging. This code is appropriate for diagnostic purposes and should not be used for cervical spine imaging. It is important to note that the use of contrast material is a key factor in determining when to report this code.

6. Documentation requirements

To support a claim for CPT 70492, providers must document the following information:

• Reason for the CT scan of the soft tissue structures in the neck
• Details of the contrast material administered, including the route of administration
• Date and time of the procedure
• Specific soft tissue structures imaged
• Findings or abnormalities identified during the imaging
• Signature of the provider performing the procedure

7. Billing guidelines

When billing for CPT 70492, providers should ensure that the procedure meets the criteria outlined in the official description. It is important to accurately report the use of contrast material and the specific soft tissue structures imaged. Providers may need to separately report the contrast material using a supply code or a HCPCS Level II code, depending on payer policies. Modifier 26 should be appended to the radiology code if reporting only the physician’s interpretation, while modifier TC should be appended for reporting only the technical component. However, payer policies may exempt hospitals from appending modifier TC. It is crucial to review individual payer guidelines for specific billing requirements and coverage.

8. Historical information

CPT 70492 was added to the Current Procedural Terminology system on January 1, 1990. The code underwent a change on January 1, 2003, with an updated description. Since then, there have been no further updates or changes to the code.

9. Examples

1. A radiologist performing a CT scan of the soft tissue structures in the neck without contrast, followed by the administration of contrast material and further imaging to evaluate a patient with suspected thyroid nodules.
2. A head and neck surgeon ordering a CT scan of the soft tissue structures in the neck without contrast, followed by the administration of contrast material and further imaging to assess the extent of a neck mass in a patient with suspected malignancy.
3. An otolaryngologist utilizing a CT scan of the soft tissue structures in the neck without contrast, followed by the administration of contrast material and further imaging to evaluate a patient with recurrent tonsillitis and suspected peritonsillar abscess.
4. An oncologist requesting a CT scan of the soft tissue structures in the neck without contrast, followed by the administration of contrast material and further imaging to monitor the response to treatment in a patient with metastatic lymphadenopathy.
5. An emergency medicine physician ordering a CT scan of the soft tissue structures in the neck without contrast, followed by the administration of contrast material and further imaging to assess the presence of airway obstruction in a patient with acute respiratory distress.