Summary & Overview
CPT 70490: CT Neck Soft Tissue, Non-Contrast
CPT code 70490 represents a non-contrast computed tomography (CT) examination of the neck’s soft tissue structures. As a diagnostic imaging code, it is used nationally to document and bill for CT studies that evaluate soft-tissue anatomy and pathology in the neck when intravenous or oral contrast is not administered. This code matters for clinical workflows and radiology utilization monitoring because it captures a distinct imaging modality and clinical scenario that differs from contrast-enhanced CT and from CT angiography.
Key payers referenced in this analysis include Aetna, Blue Cross Blue Shield, Cigna, UnitedHealthcare, and Medicare. Readers will find a concise overview of the clinical context for non-contrast neck CT, typical sites of service, and the payer landscape covered. The publication also summarizes benchmarks and common billing modifiers associated with radiology services, highlights policy considerations that affect coverage and prior authorization practices, and explains how CPT code 70490 relates to other neck and head imaging codes in clinical documentation and claims workflows.
This national-level summary is intended to clarify what CPT code 70490 denotes, why it is used, and what topics — including reimbursement benchmarks, documentation expectations, and policy updates — are addressed in the full publication.
Billing Code Overview
CPT code 70490 describes a computed tomography (CT) exam of the neck soft tissue structures performed without contrast. This service captures cross-sectional imaging focused on the soft tissues of the neck to evaluate anatomy and pathology such as masses, infections, or airway-related concerns.
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Service type: Diagnostic imaging — non-contrast CT of neck soft tissues
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Typical site of service: Outpatient radiology department, hospital imaging center, or ambulatory imaging clinic
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Clinical & Coding Specifications
Clinical Context
A typical patient presenting for 70490 is an adult or pediatric patient with symptoms localized to the neck soft tissues such as a palpable neck mass, suspected lymphadenopathy, evaluation of a known neck infection or abscess, trauma to the anterior neck, or concern for soft tissue foreign body. The clinical workflow begins with the referring clinician (often primary care, otolaryngology, or emergency medicine) documenting history and indication for a noncontrast CT of the neck soft tissues. The patient is screened for contraindications to CT (e.g., inability to cooperate, pregnancy concerns) and informed consent for imaging is obtained according to site policy.
On the day of service the patient is registered in the radiology department or imaging center (typical site of service: outpatient radiology suite, hospital radiology department, or emergency department imaging). A technologist performs the CT acquisition per protocol for neck soft tissues without intravenous contrast. Images are archived to PACS and a radiologist interprets the study, generating a report that addresses the indication (mass characterization, infection extent, airway compromise, fracture evaluation of soft tissue structures, etc.). The radiologist’s report and any recommended follow-up are sent to the referring clinician for management decisions. Billing uses 70490 to represent the CT exam of the neck soft tissues performed without contrast, with appropriate modifiers appended as clinically applicable.
Coding Specifications
| Modifier | Description | When to Use |
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