How To Use CPT Code 76100

CPT 76100 describes the radiologic examination of a single plane body section using specialized X-ray equipment. 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 76100?

CPT 76100 is used to describe a radiologic examination that focuses on a specific plane of the body. This procedure utilizes specialized X-ray equipment to capture images of one slice of the body in sharp focus, while blurring out the sections above and below that particular level. By emphasizing a single plane, this technique allows for clearer evaluation and localization of lesions, particularly in areas such as the lungs and bones.

2. Official Description

The official description of CPT code 76100 is: ‘Radiologic examination, single plane body section (e.g., tomography), other than with urography.’

3. Procedure

1. The provider uses specialized X-ray equipment that allows for the viewing of only one plane of the body.
2. By synchronously moving the X-ray tube and film, the provider captures images that highlight a specific slice of the body, while blurring out the sections above and below.
3. This technique, known as tomography, produces sharper images of the structure being studied with minimal superimposition of other structures.
4. The procedure is particularly useful in evaluating and locating lesions in areas such as the lungs and bones.

4. Qualifying circumstances

CPT 76100 is typically performed when there is a need to focus on a specific plane of the body for diagnostic purposes. It is commonly used to evaluate and locate lesions in areas such as the lungs and bones. This procedure requires specialized X-ray equipment and expertise to capture images that emphasize a single plane while blurring out other sections. It is important to note that this code should not be used for urography, which is a separate X-ray examination specifically for checking the kidneys and ureters.

5. When to use CPT code 76100

CPT code 76100 should be used when there is a need to perform a radiologic examination that focuses on a single plane of the body, other than for urography. It is appropriate when the provider utilizes specialized X-ray equipment to capture images that highlight a specific slice of the body, while blurring out the sections above and below. This procedure is particularly useful for evaluating and locating lesions in areas such as the lungs and bones.

6. Documentation requirements

To support a claim for CPT 76100, the provider must document the following information:

• Reason for performing the radiologic examination
• Specific plane of the body that was focused on
• Date and time of the procedure
• Details of the images captured and any findings
• Signature of the provider performing the procedure

7. Billing guidelines

When billing for CPT 76100, it is important to ensure that the procedure was performed using specialized X-ray equipment to capture images of a single plane of the body. If only the physician’s interpretation is being reported, append modifier 26 to the radiology code. If only the technical component is being reported, append modifier TC to the radiology code. However, note that payer policies may exempt hospitals from appending modifier TC, as the hospital’s portion is inherently technical. When reporting a global service in which one provider renders both the professional and technical components, do not append a professional or technical modifier to the radiology code.

8. Historical information

CPT 76100 was added to the Current Procedural Terminology system on January 1, 1990. There have been no updates to the code since its addition.

9. Examples

1. A radiologist performing a tomographic examination of the chest to evaluate a suspected lung lesion.
2. An orthopedic surgeon ordering a tomographic examination of the spine to assess a specific vertebral level.
3. A pulmonologist utilizing tomography to locate and evaluate a pulmonary nodule in a patient with a history of lung cancer.
4. A radiology technician capturing tomographic images of a patient’s skull to assess the extent of a cranial fracture.
5. An oncologist requesting a tomographic examination of the pelvis to determine the size and location of a suspected tumor.
6. A radiologist performing a tomographic examination of the temporomandibular joint to assess the presence of any abnormalities.
7. A podiatrist utilizing tomography to evaluate a specific plane of the foot for the presence of a stress fracture.
8. A dentist ordering a tomographic examination of the maxilla to assess the position of impacted teeth.
9. An otolaryngologist utilizing tomography to evaluate the sinuses and identify any signs of sinusitis.
10. A rheumatologist ordering a tomographic examination of the hands to assess the presence of erosions in patients with rheumatoid arthritis.