CPT Code 70450: CT scan of the head or brain, without contrast

What is code 70450?

CPT code 70450 refers to a computed tomography (CT) scan of the head or brain performed without contrast material. This diagnostic imaging procedure uses advanced X-ray technology to produce detailed cross-sectional images of intracranial structures, allowing healthcare providers to assess for stroke, intracranial bleeding, brain tumours or metastases, and other neurological symptoms or deficits. The scan is typically ordered when rapid evaluation of brain pathology is needed, particularly in patients presenting with acute confusion, head trauma, seizures, or unexplained loss of consciousness.

A non-contrast CT of the head is often performed in both emergency and outpatient settings because it is quick, widely accessible, and highly effective for initial triage and diagnosis. While contrast-enhanced studies are sometimes necessary for specific conditions, a non-contrast scan is generally preferred when assessing for acute stroke, hemorrhage, or mass effect.

Although CPT 70450 applies strictly to the head or brain, it is important to distinguish it from neck CT scans, which evaluate cervical soft tissues and vasculature. Head and neck imaging may be ordered concurrently depending on the clinical presentation, especially when symptoms span multiple anatomical regions.

A head CT scan without contrast typically ranges from 5 to 15 minutes. However, scan time may vary based on the patient's ability to remain still, the imaging protocol used, and institutional workflow. Because of its speed, diagnostic value, and non-invasive nature, CPT 70450 remains a core imaging modality across all age groups in modern neurological care.

Documentation requirements

Proper documentation is essential to support medical necessity—such as evaluation for conditions like brain tumors or metastases—ensure accurate coding, and comply with payer requirements. The following components should be included in the patient’s medical record:

Clinical indication and medical necessity

Clearly state the reason for ordering the scan, such as a sudden-onset headache, head trauma, altered mental status, suspected stroke, or evaluation of known or suspected brain lesions. The indication must support the need for non-contrast imaging, particularly when contrast is not clinically appropriate.

Anatomical site and scan details

Specify that the CT was performed on the head or brain and confirm that no contrast material was administered. Include laterality if relevant, especially when evaluating focal findings or asymmetrical symptoms.

Provider order and interpretation

Ensure that a qualified provider ordered the CT scan and that a formal interpretation and report were completed. The radiologist’s findings should detail abnormalities, relevant negative findings, and any follow-up imaging or intervention recommendations.

Billing guidelines

CPT 70450 is reported for non-contrast CT imaging of the head or brain. To ensure accurate reimbursement, billing teams must follow correct coding practices and understand payer-specific rules.

Do not use contrast-related modifiers

Because 70450 specifies that the scan is performed without contrast, do not append modifiers such as -TC (technical component) or -26 (professional component) unless the service is split between separate entities (e.g., hospital vs. radiologist billing).

Avoid duplication with other imaging codes

When multiple CT scans are performed (e.g., head and neck), ensure that each scan is separately documented and coded using the appropriate CPT code. If both contrast and non-contrast scans are performed during the same session, a different CPT code such as 70470 (with and without contrast) should be used instead.

Medicare and commercial coverage

Most payers, including Medicare, reimburse CPT 70450 when it is medically necessary and properly documented. Be aware of frequency limitations, prior authorisation requirements, and any local coverage determinations (LCDs) that may affect payment.

Other relevant CPT codes

• 70460: CT scan of the head or brain, with contrast
• 70480: CT scan of the orbit, sella, posterior fossa, or outer, middle, or inner ear, performed without contrast material.
• 70481: CT scan of the neck, with contrast