Summary & Overview
CPT 74177: CT Scan of Abdomen and Pelvis with and without Contrast
CPT code 74177 is a critical diagnostic tool in radiology, representing a computed tomography (CT) scan of the abdomen and pelvis performed both without and with contrast material. This procedure is widely used to evaluate patients with abdominal pain, suspected obstructions, kidney stones, malignancies, and acute appendicitis, among other conditions. Its comprehensive imaging capabilities make it a cornerstone in the assessment and management of complex abdominal and pelvic cases across the United States.
Major national payers, including Aetna, Blue Cross Blue Shield, Cigna Health, Medicare, and UnitedHealthcare, provide coverage for this service, reflecting its clinical importance and broad utilization. The procedure is typically performed in hospital outpatient departments or office-based radiology practices, ensuring accessibility for a wide patient population.
This publication offers an in-depth overview of 74177, including clinical indications, relevant ICD-10 diagnoses, common billing modifiers, and related CPT codes. Readers will gain insight into payer coverage, coding nuances, and the procedure's role in diagnostic radiology. The analysis also highlights policy updates and benchmarks relevant to medical billing and reimbursement, supporting stakeholders in understanding the evolving landscape of CT imaging services.
CPT Code Overview
CPT code 74177 represents a computed tomography (CT) scan of the abdomen and pelvis performed without contrast material, followed by contrast material(s), and further sections both with and without contrast. This procedure is classified under Diagnostic Radiology / Computed Tomography and is commonly performed in a hospital outpatient setting (POS 22) or an office setting (POS 11). The scan provides detailed imaging to assist in diagnosing a range of abdominal and pelvic conditions, supporting clinical decision-making for patients presenting with complex symptoms.
Clinical & Coding Specifications
Clinical Context
A patient presents to the hospital outpatient department or physician office with symptoms such as abdominal pain, suspected intestinal obstruction, or possible kidney stones. The clinician orders a computed tomography (CT) scan of the abdomen and pelvis to evaluate the underlying cause. The procedure involves an initial scan without contrast, followed by administration of contrast material, and then further imaging both with and without contrast. This workflow allows for comprehensive assessment of abdominal and pelvic structures, aiding in diagnosis of conditions like appendicitis, malignancy, or urinary calculi.
Coding Specifications
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Modifier
26: Indicates the professional component of the service, used when the physician interprets the CT images but does not own the equipment. -
Modifier
TC: Indicates the technical component, used when billing for the use of the equipment and technical staff, but not the interpretation.
| Modifier Code | Description |
|---|---|
26 | Professional component |