How To Use CPT Code 72191

CPT 72191 describes the procedure of computed tomographic angiography (CTA) of the pelvis, which involves the use of contrast material(s) and may include noncontrast images. This article will cover the description, official description, procedure, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information, similar codes and billing examples.

1. What is CPT Code 72191?

CPT 72191 is used to describe the procedure of computed tomographic angiography (CTA) of the pelvis. This involves the use of contrast material(s) to enhance the visibility of the blood vessels in the pelvic region. The provider may also take noncontrast images as part of the procedure. CPT 72191 is used to accurately diagnose, manage, and treat conditions such as aneurysms or blood clots in the pelvic blood vessels.

2. Official Description

The official description of CPT code 72191 is: ‘Computed tomographic angiography, pelvis, with contrast material(s), including noncontrast images, if performed, and image postprocessing.’

3. Procedure

1. The patient is positioned in a supine position on the CT scanner table.
2. An intravenous (IV) line is inserted into the patient for the administration of contrast material.
3. The provider supervises the administration of the IV contrast, scout films or preliminary images, and the actual pelvic image acquisition.
4. The CT scanner moves around the patient’s body, taking pictures of the pelvis.
5. The images are displayed on a monitor screen for the provider to review and analyze.
6. The provider performs post-processing image reconstruction to select the most relevant view of the images taken.
7. The provider interprets the results and prepares a report of their findings.

4. Qualifying circumstances

CPT 72191 is used for patients who require computed tomographic angiography (CTA) of the pelvis to diagnose, manage, or treat conditions such as aneurysms or blood clots in the pelvic blood vessels. The use of contrast material(s) is necessary to enhance the visibility of the blood vessels during the procedure. Noncontrast images may also be taken if deemed necessary by the provider. It is important to note that CPT 72191 should not be reported in conjunction with other specific codes, as mentioned in the notes.

5. When to use CPT code 72191

CPT code 72191 should be used when a provider performs computed tomographic angiography (CTA) of the pelvis with the use of contrast material(s) and potentially noncontrast images. This code accurately represents the specific procedure performed and should be used when reporting the service. However, it is important to review the notes and guidelines to ensure that CPT 72191 is not reported in conjunction with other specific codes.

6. Documentation requirements

To support a claim for CPT 72191, the provider must document the following information:

• Indication for the procedure and the medical necessity
• Details of the contrast material(s) used
• Date and time of the procedure
• Specific images acquired, including noncontrast images if performed
• Post-processing image reconstruction performed
• Interpretation and analysis of the images
• Findings and conclusions

7. Billing guidelines

When billing for CPT 72191, it is important to ensure that the procedure meets the specific criteria outlined in the code description. The use of contrast material(s) and potentially noncontrast images should be documented and supported by medical necessity. It is also crucial to review the notes and guidelines to ensure that CPT 72191 is not reported in conjunction with other specific codes. Modifier TC may be appended to the radiology code if reporting only the technical component, while modifier 26 may be appended if reporting only the physician’s interpretation.

8. Historical information

CPT 72191 was added to the Current Procedural Terminology system on January 1, 2001. There have been historical changes to the code, including a code change on January 1, 2008, which modified the description to include contrast material(s) followed by further sections and image post-processing.

9. Examples

1. A patient undergoes computed tomographic angiography (CTA) of the pelvis with contrast material(s) to evaluate for the presence of an aneurysm in the pelvic blood vessels.
2. A provider performs CTA of the pelvis with contrast material(s) and noncontrast images to assess for blood clots in the pelvic blood vessels.
3. Computed tomographic angiography (CTA) of the pelvis with contrast material(s) is performed on a patient to diagnose and manage a suspected vascular abnormality in the pelvic region.
4. A provider utilizes CTA of the pelvis with contrast material(s) to evaluate the effectiveness of a previously placed vascular stent in the pelvic blood vessels.
5. CTA of the pelvis with contrast material(s) and noncontrast images is performed on a patient to assess the patency of the pelvic blood vessels following a surgical procedure.