CPT 74170 CT Abdomen Reimbursement & Policy | OpenPayer

Summary & Overview

CPT 74170: CT Abdomen Without and With Contrast

CPT code 74170 covers computed tomography of the abdomen performed both without and with intravenous contrast. This dual-phase CT is a common diagnostic tool for evaluating a wide range of abdominal conditions — from acute abdominal pain and suspected infection to characterization of masses and staging of malignancy — and carries significant national relevance due to high utilization in emergency and outpatient imaging settings. Key payers in the national analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise explanation of the clinical and billing intent of the code, typical sites of service, and the payer landscape addressed. The publication outlines common reimbursement considerations, typical modifiers used in practice (listed separately), and operational factors that affect billing, such as technical versus professional components and site-of-service influences. It also summarizes benchmarking context and highlights policy updates and coverage nuances that commonly affect authorization and payment across major national payers. Data not available in the input is noted where applicable; the focus remains on clarifying the service captured by CPT code 74170, how it is commonly delivered, and what elements influence billing and coverage decisions at a national level.

AetnaBlue Cross Blue ShieldCigna HealthUnitedHealthcareMedicare74170CPTCT abdomendiagnostic imagingradiologyabdominal CToutpatient imaginghospital imaging

Billing Code Overview

CPT code 74170 describes a computed tomography (CT) examination of the abdomen performed with and without intravenous contrast. The procedure involves obtaining a set of cross-sectional images without contrast, administering intravenous contrast, and then acquiring additional post-contrast images to assist in diagnosing and managing abdominal conditions.

Service type: Diagnostic imaging — CT abdomen with and without contrast
Typical site of service: Hospital outpatient imaging center, ambulatory imaging center, or hospital radiology department

Data not available in the input.

Clinical & Coding Specifications

Clinical Context

A 56-year-old male presents to the emergency department with acute, severe right lower quadrant abdominal pain, nausea, and low-grade fever. The emergency physician documents concern for appendicitis versus an alternative intra‑abdominal process such as renal colic or diverticulitis. The patient has no known contrast allergy and normal renal function per recent labs, so the radiology team schedules a computed tomography (CT) scan of the abdomen with both noncontrast and contrast-enhanced phases to evaluate for appendiceal inflammation, obstructing ureteral stone, or intra‑abdominal abscess.

The clinical workflow: the patient is registered in radiology, screening questions for contrast allergy and renal function are reviewed, and informed consent for intravenous contrast is obtained when appropriate. A noncontrast abdominal CT is performed first to detect calcified stones and baseline anatomy. Intravenous contrast is then administered, and post-contrast arterial/venous phase images are acquired. Images are reconstructed and reviewed by the interpreting radiologist, who documents findings, impression, and whether additional imaging or image-guided intervention is required. The study is coded using 74170 for CT abdomen with and without contrast, and appropriate modifier(s) are appended per payer and clinical circumstances.

Coding Specifications

Modifier	Description	When to Use
`26`	Professional component

CPT 74022: Abdominal Radiography with Single Chest View for Acute Abdomen

CPT-74183-ABDOMINAL-MRI-WITH-AND-WITHOUT-CONTRAST

CPT 74183: MRI of Abdomen Without and With Contrast

CPT-74190-PERITONEAL-AIR-CONTRAST-RADIOGRAPHIC-STUDY

CPT 74190: Radiographic Study After Intraperitoneal Air or Contrast Injection

CPT-74175-ABDOMINAL-CT-ANGIOGRAPHY-CONTRAST

CPT 74175: Abdominal CT Angiography with Contrast

CPT-74150-CT-ABDOMEN-NON-CONTRAST

CPT 74150: CT Scan of Abdomen Without Contrast

CPT-74160-CT-ABDOMEN-WITH-CONTRAST

CPT 74160: CT Scan of Abdomen with Intravenous Contrast

CPT-74185-MRI-ANGIOGRAPHY-ABDOMEN

CPT 74185: MRI Angiography of Abdominal Blood Vessels

CPT-74021-ABDOMINAL-RADIOGRAPHIC-3-OR-MORE-VIEWS

CPT 74021: Abdominal X-ray, Three or More Views

CPT-74182-MRI-ABDOMEN-WITH-CONTRAST

CPT 74182: MRI of Abdomen With Contrast

CPT-74019-ABDOMEN-XRAY-TWO-VIEWS

CPT 74019: Abdomen X‑ray, Two Views

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Taxonomy Code	Specialty	Notes
261QM0800X	Diagnostic Radiology	Primary specialty performing and interpreting abdominal CT studies.
2085R0200X	Emergency Medicine	Orders and triages acute imaging in emergency presentations.
2080S0126X	General Surgery	Uses CT results for operative decision-making in appendicitis, diverticulitis, or bowel obstruction.
208000000X	Internal Medicine	Manages inpatient medical conditions where abdominal CT is requisitioned for diagnosis.
207K00000X	Family Medicine	Orders outpatient CT for abdominal pain workup when appropriate.

Related Diagnoses

ICD-10 Code	Description	Clinical Relevance
`K35.80`	Acute appendicitis without perforation or abscess	Common indication for abdominal CT to confirm diagnosis and plan surgery.
`N20.0`	Calculus of kidney	Noncontrast images detect renal/ureteral stones; contrast phases assess secondary findings.
`K57.20`	Diverticulitis of large intestine without perforation or abscess	CT abdomen with contrast evaluates inflammation, complications, and abscess.
`K56.69`	Other intestinal obstruction	CT identifies transition point, degree of obstruction, and ischemia.
`K65.9`	Peritonitis, unspecified	CT detects inflammatory fluid, sources of infection, and abscess formation.

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`70450`	Computed tomography, head or brain; without contrast material	May be performed in parallel if concomitant head symptoms require noncontrast CT; unrelated body region.
`74160`	Computed tomography, abdomen; without contrast material	Alternative single-phase study when only noncontrast imaging is required (prior to contrast administration).
`74177`	Computed tomography, abdomen and pelvis; with contrast material, including non-contrast images when performed, and image post-processing	Used when CT of both abdomen and pelvis with contrast is performed; broader anatomic coverage than `74170`.
`74022`	Radiologic examination, abdomen; 1 or 2 views	Plain abdominal radiograph sometimes used initially for suspected bowel obstruction or free air before CT.
`10030`	Incision and drainage of hematoma, seroma or fluid collection	Potentially performed after CT-guided diagnosis of an abscess; CT findings guide procedure planning.

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