How To Use CPT Code 74022

CPT 74022 describes the radiologic examination of the complete acute abdomen series, including two or more views of the abdomen and a single view of the chest. 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 74022?

CPT 74022 is used to describe a radiologic examination that includes two or more views of the entire abdomen and a single view of the chest. This code is typically used when there is a suspected acute abdomen, which is a condition that requires immediate diagnosis and treatment. The examination helps assess the organs in the abdomen, such as the stomach, liver, spleen, large and small intestines, and diaphragm, to aid in the diagnosis of the underlying cause of the acute abdomen.

2. Official Description

The official description of CPT code 74022 is: ‘Radiologic examination, complete acute abdomen series, including 2 or more views of the abdomen (eg, supine, erect, decubitus), and a single view chest.’

3. Procedure

1. The patient is taken to the X-ray room for the radiologic examination.
2. The technician positions the X-ray machine over the abdomen.
3. The technician instructs the patient to hold their breath and stay still for 2 to 3 seconds while the X-ray images are taken.
4. The technician takes two or more views of the abdomen, capturing different poses and views of the digestive system.
5. The views may include the patient standing upright (erect) with X-rays passing front to back (anterior to posterior or AP view) or back to front (posterior to anterior or PA view).
6. The views may also include the patient in supine (face up), prone (face down), and lateral decubitus positions (lying on the left or right side).
7. A single view of the chest is also taken to complete the examination.

4. Qualifying circumstances

CPT 74022 is used when there is a suspected acute abdomen, which is an emergency condition that can be caused by severe trauma, infection, inflammation, arterial occlusion or ruptured aneurysm, or other conditions. Patients with an acute abdomen typically present with sudden abdominal pain. The examination helps evaluate the organs in the abdomen to aid in the diagnosis and treatment of the underlying cause of the acute abdomen.

5. When to use CPT code 74022

CPT code 74022 should be used when a radiologic examination of the complete acute abdomen series is performed, including two or more views of the abdomen and a single view of the chest. This code is appropriate when there is a suspected acute abdomen and the examination is necessary to aid in the diagnosis and treatment of the condition.

6. Documentation requirements

To support a claim for CPT code 74022, the documentation should include:

• A clear indication of the suspected acute abdomen
• Details of the specific views taken during the examination
• Date and time of the examination
• Any additional relevant information or findings
• Signature of the provider who performed or interpreted the examination

7. Billing guidelines

When billing for CPT code 74022, ensure that the examination includes two or more views of the abdomen and a single view of the chest. It is important to follow payer guidelines and append the appropriate modifiers, such as modifier 26 for the professional component or modifier TC for the technical component, if applicable. If reporting a global service where one provider renders both the professional and technical components, modifiers may not be necessary.

8. Historical information

CPT code 74022 has undergone historical changes. On January 1, 2020, the code description was updated to include the specific views of the abdomen (supine, erect, and/or decubitus) and a single view of the chest. Prior to that, on January 1, 2003, the code description was further revised to include the upright PA chest view. CPT code 74022 was initially added to the Current Procedural Terminology system on January 1, 1990.

9. Examples

1. A patient presents with sudden severe abdominal pain. The radiologic examination includes two views of the abdomen and a single view of the chest to aid in the diagnosis of the acute abdomen.
2. A trauma patient is brought to the emergency department with suspected internal injuries. The radiologic examination consists of two or more views of the abdomen and a single view of the chest to assess for any acute abdominal conditions.
3. A patient with suspected gastrointestinal obstruction undergoes a radiologic examination that includes two or more views of the abdomen and a single view of the chest to help identify the cause of the obstruction.
4. A patient with suspected appendicitis undergoes a radiologic examination that includes two or more views of the abdomen and a single view of the chest to aid in the diagnosis and treatment of the acute abdomen.
5. A patient with suspected bowel perforation undergoes a radiologic examination that includes two or more views of the abdomen and a single view of the chest to assess the extent of the perforation and guide surgical intervention.
6. A patient with suspected abdominal trauma undergoes a radiologic examination that includes two or more views of the abdomen and a single view of the chest to evaluate for any injuries or internal bleeding.
7. A patient with suspected abdominal infection undergoes a radiologic examination that includes two or more views of the abdomen and a single view of the chest to aid in the diagnosis and treatment of the acute abdomen.