Summary & Overview
CPT 72192: CT Scan of Pelvis Without Contrast
CPT code 72192 represents a non-contrast computed tomography (CT) examination of the pelvis. This diagnostic imaging code is used when pelvic CT images are obtained without intravenous or oral contrast material, and it is commonly employed in emergency, inpatient, and outpatient settings to evaluate trauma, acute abdominal or pelvic pain, suspected stone disease, or other structural abnormalities. Nationally, accurate coding for CT pelvis without contrast is important for clinical documentation, care coordination, and claims adjudication across payers.
Key payers covered in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. The publication summarizes payer coverage patterns, reimbursement benchmarks, coding guidance, and relevant clinical context for appropriate use of non-contrast pelvic CT.
Readers will find a concise overview of what CPT code 72192 denotes, typical sites of service, and the clinical situations that commonly prompt use of this code. The report also provides payer-level coverage notes where available, comparative benchmarks for utilization and reimbursement, and any recent policy updates affecting imaging authorization and documentation requirements. Data not available in the input is noted where applicable.
Billing Code Overview
CPT code 72192 describes a computed tomography (CT) scan of the pelvis performed without contrast. The service is an imaging procedure that acquires cross-sectional CT images of the pelvic anatomy using ionizing radiation, without administration of intravenous or oral contrast agents.
Service type: Diagnostic imaging — CT scan, non-contrast
Typical site of service: Outpatient imaging center or hospital radiology department
Clinical & Coding Specifications
Clinical Context
A 57-year-old male presents to the emergency department with acute onset pelvic pain after a fall at home. He has localized tenderness over the pelvic brim and difficulty ambulating. The ED physician requests diagnostic imaging to evaluate for pelvic fractures and to assess for associated hematoma but opts for noncontrast imaging due to concern for renal insufficiency (elevated creatinine) and the need for rapid assessment. The CT technologist performs a CT of the pelvis without contrast (CPT 72192) in the radiology department. The study is acquired using axial and multiplanar reconstructions, images are reviewed by a radiologist, and a final report documents osseous injury, presence or absence of active hemorrhage, and associated soft-tissue findings.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
26 | Professional component | When billing only the interpreting physician’s service separate from facility technical component |
TC | Technical component | When billing only the facility/technical portion of the service |