How To Use CPT Code 74178

CPT 74178 describes the diagnostic procedure of computed tomography (CT) of the abdomen and pelvis. 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 74178?

CPT 74178 is used to describe the diagnostic procedure of computed tomography (CT) of the abdomen and pelvis. This procedure involves the use of X-ray beams and electronic detectors to capture cross-sectional images of the internal organs in the abdomen and pelvis. It is commonly performed to diagnose the cause of abdominal or pelvic pain, as well as other abnormalities in these regions.

2. Official Description

The official description of CPT code 74178 is: ‘Computed tomography, abdomen and pelvis; without contrast material in one or both body regions, followed by contrast material(s) and further sections in one or both body regions.’

3. Procedure

1. The patient is positioned in a supine position on the scanner table.
2. The provider instructs the patient to hold their breath and remain still for a few seconds while the images are taken.
3. The CT scanner, equipped with an X-ray tube and detectors, rotates around the patient, measuring the amount of radiation absorbed in the abdomen and pelvis.
4. The table moves through the scanner, allowing for images to be captured from different angles.
5. Initially, the procedure is performed without the administration of intravenous contrast material.
6. The provider then repeats the examination, injecting contrast material through a small catheter in the patient’s vein.
7. The images are displayed on a monitor screen for interpretation.

4. Qualifying circumstances

CPT 74178 is typically performed when there is a need to evaluate the internal organs in the abdomen and pelvis for diagnostic purposes. It is commonly used to investigate the cause of abdominal or pelvic pain, as well as to detect and evaluate abnormalities in these regions. The procedure may be performed with or without the use of contrast material, depending on the specific clinical indications and the provider’s judgment.

5. When to use CPT code 74178

CPT code 74178 should be used when a provider performs a CT scan of the abdomen and pelvis, both with and without the use of contrast material. This code represents the technical and professional components of the service. It is important to note that CPT code 74178 should not be reported in conjunction with codes 72192-72194 and 74150-74170.

6. Documentation requirements

To support a claim for CPT 74178, the provider must document the following information:

• Reason for the CT scan of the abdomen and pelvis
• Whether contrast material was used and the route of administration
• Date and time of the procedure
• Specific findings or abnormalities observed
• Interpretation and report of the CT scan
• Signature of the provider performing the service

7. Billing guidelines

When billing for CPT 74178, it is important to ensure that the procedure was performed as described in the official description. Providers should also follow payer guidelines regarding the reporting of contrast material separately, if applicable. Modifier TC should be appended to the radiology code when reporting only the technical component, while modifier 26 should be appended when reporting only the professional component. However, it is important to check individual payer policies for specific requirements and exemptions.

8. Historical information

CPT 74178 was added to the Current Procedural Terminology system on January 1, 2011. There have been no updates to the code since its addition.

9. Examples

1. A patient undergoes a CT scan of the abdomen and pelvis without contrast to investigate the cause of persistent abdominal pain.
2. A provider performs a CT scan of the abdomen and pelvis with contrast to evaluate a suspected abdominal mass.
3. A patient with a history of pelvic inflammatory disease undergoes a CT scan of the abdomen and pelvis to assess for any complications.
4. A provider orders a CT scan of the abdomen and pelvis without contrast to screen for kidney stones in a patient with recurrent flank pain.
5. A patient with suspected appendicitis undergoes a CT scan of the abdomen and pelvis with contrast to aid in the diagnosis.
6. A provider performs a CT scan of the abdomen and pelvis without contrast to evaluate a patient with unexplained weight loss and gastrointestinal symptoms.
7. A patient with a history of ovarian cancer undergoes a CT scan of the abdomen and pelvis with contrast to monitor for disease recurrence.
8. A provider orders a CT scan of the abdomen and pelvis without contrast to assess the extent of liver cirrhosis in a patient with chronic liver disease.
9. A patient with suspected diverticulitis undergoes a CT scan of the abdomen and pelvis with contrast to confirm the diagnosis.
10. A provider performs a CT scan of the abdomen and pelvis without contrast to evaluate a patient with suspected bowel obstruction.