CPT code 74178 represents a diagnostic computed tomography (CT) examination of the abdomen and pelvis performed first without contrast and then with contrast, including additional sections as needed. This combined non-contrast and contrast-enhanced CT is commonly used to evaluate acute abdominal or pelvic pain and to detect structural abnormalities of intra‑abdominal and pelvic organs. Nationally, the code is important for standardized reporting, appropriate imaging selection, and payer coverage determinations given its frequent use in emergency and outpatient settings.

Key payers covered in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise explanation of the clinical context for CPT code 74178, typical sites of service, and the service type. The publication summarizes common billing considerations and lists frequently used modifiers (input-provided), while providing benchmarks and policy-relevant notes where available. It also identifies missing input elements such as associated taxonomies and ICD-10 diagnoses when those data are not provided.

This piece is designed for clinicians, administrators, and billing professionals seeking a clear, national-level overview of the CPT code, how it is used clinically, and the payer landscape relevant to this combined CT abdomen and pelvis study.