How To Use CPT Code 76497

CPT 76497 describes a specific computed tomography procedure that does not have a designated code. This article will cover the official description, procedure, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information, similar codes and billing examples.

1. What is CPT Code 76497?

CPT 76497 can be used to report computed tomography procedures that do not have a specific code. This code is used when the provider performs a diagnostic or interventional procedure using computed tomography that is not represented by any of the standard and active CPT codes available.

2. Official Description

The official description of CPT code 76497 is: ‘Unlisted computed tomography procedure (eg, diagnostic, interventional).’ There are no additional notes available for this code.

3. Procedure

1. The provider performs a computed tomography procedure using a rotating X-ray tube and X-ray detectors to produce a tomogram, which is a computer-generated cross-sectional image.
2. This procedure is used for diagnostic purposes to diagnose a condition or for interventional purposes to treat a condition.
3. The provider uses computed tomography to manage and treat various diseases.

4. Qualifying circumstances

CPT 76497 can be used when the provider performs a computed tomography procedure that does not have a specific code available. This code is appropriate when there is no other CPT code that accurately represents the service provided.

5. When to use CPT code 76497

CPT code 76497 should be used when there is no specific CPT code available to accurately describe the computed tomography procedure performed by the provider. It is important to note that this code should only be used when there is no other appropriate code that closely approximates the service provided.

6. Documentation requirements

To support a claim for CPT 76497, the provider must include the following documentation:

• A cover letter explaining the reason for choosing the unlisted code instead of a defined, active code
• Comparison of the service to similar codes to justify the claim amount
• Operative notes or other relevant documentation to strengthen the claim and avoid possible denial

7. Billing guidelines

When billing for CPT 76497, it is important to follow these guidelines:

• Submit a cover letter explaining the reason for using the unlisted code instead of a specific code
• Include one or more similar codes and compare the service to those codes to justify the claim amount
• Provide operative notes or other relevant documentation to support the claim and avoid possible denial

8. Historical information

CPT 76497 was added to the Current Procedural Terminology system on January 1, 2003. There have been no updates to the code since its addition.

9. Examples

1. A provider performs a computed tomography procedure to diagnose a rare condition that does not have a specific code available.
2. A patient requires an interventional computed tomography procedure to treat a complex medical condition that does not have a designated code.
3. A provider uses computed tomography to manage and treat a disease that does not have a specific code available.
4. A patient undergoes a computed tomography procedure for diagnostic purposes, but there is no appropriate code to accurately describe the service provided.
5. A provider performs an interventional computed tomography procedure to treat a condition that does not have a specific code available.
6. A patient requires a computed tomography procedure to diagnose a rare disease that does not have a designated code.
7. A provider uses computed tomography to manage and treat a complex medical condition that does not have a specific code available.
8. A patient undergoes a computed tomography procedure for interventional purposes, but there is no appropriate code to accurately describe the service provided.
9. A provider performs a computed tomography procedure to diagnose a condition that does not have a specific code available.
10. A patient requires an interventional computed tomography procedure to treat a rare disease that does not have a designated code.