Summary & Overview
CPT 70470: CT Scan of Head or Brain with and without Contrast
CPT code 70470 is a widely used billing code for computed tomography (CT) scans of the head or brain, performed first without contrast and then with contrast material. This diagnostic imaging procedure is essential for evaluating a range of neurological conditions, including trauma, stroke, and unexplained headaches. The code is recognized by major national payers such as Aetna, Blue Cross Blue Shield, Cigna Health, Medicare, and UnitedHealthcare, ensuring broad coverage across the United States.
This publication provides a comprehensive overview of 70470, including its clinical applications, typical sites of service, and payer coverage. Readers will gain insight into the procedure's role in modern diagnostic radiology, learn about common billing practices, and understand the importance of accurate coding for reimbursement and compliance. The analysis also highlights associated modifiers, relevant taxonomies, and ICD-10 diagnoses frequently linked to this code, offering a clear picture of its place in clinical workflows and payer policies. Benchmarks and policy updates are discussed to inform stakeholders about current trends and requirements in medical billing for CT head scans.
By examining 70470 in detail, this article equips healthcare professionals, administrators, and policy analysts with the knowledge needed to navigate the complexities of diagnostic imaging billing and coverage.
CPT Code Overview
CPT code 70470 represents a computed tomography (CT) scan of the head or brain performed without contrast material, followed by contrast material(s) and additional imaging sections. This procedure is classified under diagnostic radiology (diagnostic imaging) and is commonly utilized to evaluate neurological conditions, trauma, or other abnormalities within the cranial region. Typical sites of service for this procedure include outpatient hospital settings and office locations, often designated as POS 11 or POS 22. The CT scan provides detailed cross-sectional images, aiding clinicians in diagnosis and treatment planning.
Clinical & Coding Specifications
Clinical Context
A patient presents to the outpatient hospital or office with symptoms such as sudden severe headache, confusion, loss of consciousness, or neurological deficits. The clinician suspects a possible intracranial pathology, such as hemorrhage, infarction, or other brain disorder. To evaluate the brain, a computed tomography (CT) scan of the head is ordered. The procedure involves an initial scan without contrast, followed by administration of contrast material and further imaging sections. This workflow allows for assessment of both non-contrast and contrast-enhanced views, aiding in diagnosis of conditions like traumatic subdural hemorrhage, cerebral infarction, or other brain disorders.
Coding Specifications
-
Modifier
26: Used when reporting only the professional component (interpretation and report) of the CT scan. -
Modifier
TC: Used when reporting only the technical component (equipment, supplies, and technician) of the CT scan. -
Modifier
59: Used to indicate a distinct procedural service, typically when multiple procedures are performed and need to be reported separately.
| Taxonomy Code | Specialty Name |
|---|