CPT Code 74018: Radiologic Examination of the Abdomen, Single View

What is CPT code 74018?

CPT code 74018 describes a radiologic examination of the abdomen involving a single-view X-ray. Physicians typically order this service to evaluate a patient presenting with symptoms like abdominal pain, bloating, nausea, or suspected bowel obstruction. A radiologist performs this examination using a single X-ray view—commonly an anteroposterior (AP) supine or upright projection—to visualize internal structures of the abdominal area and assist in diagnosis. This code specifically includes the interpretation and reporting of the single-view X-ray and is commonly billed in emergency departments, outpatient clinics, or inpatient facilities. Proper use of CPT 74018 ensures accurate reimbursement from payers, including Medicare, by clearly documenting medical necessity and adherence to correct coding practices.

What is a single-view abdominal X-ray?

A single-view abdominal X-ray is a radiologic examination using one ray view (typically AP supine or upright) to evaluate structures within the abdominal area. It helps physicians rapidly assess common issues like bowel obstruction, foreign bodies, abdominal distension, or kidney stones. Providers commonly order this service as an initial diagnostic study when more detailed imaging is not immediately necessary.

CPT code 74018 documentation requirements

Complete and precise documentation supports accurate reimbursement and compliance with payer guidelines.

Clinical indication for the study

Clearly document the clinical indications or symptoms prompting the single-view X-ray, such as abdominal pain, nausea, or suspected bowel obstruction. Accurate notes on patient symptoms justify medical necessity.

View obtained

Specify the exact X-ray view taken (e.g., AP supine or AP upright). Clear documentation of the ray view performed is crucial for correct coding.

Technical quality and findings

Include detailed descriptions of the technical quality of the X-ray image and clearly note all visible abdominal structures and relevant findings, aiding the radiologist’s interpretation.

Final interpretation and radiologist’s impression

Document the radiologist’s final interpretation of the imaging study, including specific diagnosis or diagnostic considerations identified from the radiologic examination.

Time and date of service

Record the exact time and date the patient underwent the imaging service, supporting accurate billing and facility reimbursement.

Patient positioning and limitations

Clearly document patient positioning, noting any factors that might have limited the exam quality, such as body habitus or difficulty obtaining clear images. These notes enhance the clinical record and billing accuracy.

CPT code 74018 billing guidelines

Accurate billing practices ensure compliance and appropriate reimbursement for CPT 74018.

Report once per exam

CPT code 74018 is reported once per radiologic examination of the abdominal area, regardless of how many attempts are made to obtain the single-view X-ray.

Do not combine with other abdominal X-ray codes

Do not bill 74018 with other abdominal X-ray codes (e.g., 74019 or 74021) for the same patient encounter. Choose the most appropriate code based on the total number of views performed during the service.

Modifiers for billing components

Use modifiers -26 (professional component) or -TC (technical component) as needed to distinguish between facility charges and physician interpretation services, ensuring accurate reimbursement from Medicare and other payers.

Medical necessity and ICD-10 diagnosis

Payers, including Medicare, typically require specific ICD-10 diagnosis codes to support medical necessity. Document clear and appropriate diagnosis codes linked to the imaging service.

Related CPT codes

• 74019 – Abdomen, two views
• 74021 – Abdomen, complete (e.g., KUB + upright + decubitus views)
• 74150–74178 – CT abdomen/pelvis imaging (more detailed evaluation)
• 71045–71048 – Chest X-rays, for evaluating respiratory symptoms