CPT Code 74177: Computed Tomography (CT) Abdomen and Pelvis with Contrast

What is CPT code 74177?

CPT code 74177 represents a computed tomography (CT) examination of the abdomen and pelvis performed with contrast material(s) during the same session. This imaging procedure is crucial in evaluating various conditions affecting the abdominal and pelvic regions. As part of the Current Procedural Terminology (CPT) coding system maintained by the American Medical Association, this code accurately describes CT scans that utilize contrast enhancement to visualize internal structures with greater clarity/

The code specifically applies when a patient undergoes imaging of the abdomen and pelvis in the same session using contrast material. Unlike separate examinations of the abdomen or pelvis alone, which would require different codes, 74177 reflects the combined CT abdomen and pelvis study with contrast material.

Healthcare providers often order this advanced imaging study for several factors that establish medical necessity:

• Abdominal pain requiring further evaluation
• Suspected masses or abnormalities in the abdominal and pelvic regions
• Follow-up assessment of known pathologies
• Evaluation of a specific organ spanning both anatomical areas
• Trauma assessment
• Oncological staging and surveillance

The distinct nature of this combined study allows for a comprehensive evaluation of conditions that may affect both anatomical regions simultaneously, making it an efficient diagnostic approach for many clinical scenarios.

CPT code 74177 documentation requirements

Proper documentation is essential to ensure compliance with coding regulations and to support medical necessity for this imaging procedure. These guidelines also ensure proper reimbursement. Healthcare providers must maintain comprehensive records that justify the use of an appropriate CPT code and ensure accurate billing.

Documentation for CT abdomen and pelvis with contrast should include:

• A specific clinical indication that necessitates imaging of both the abdomen and pelvis with contrast material
• The ordering physician's request specifying both anatomical regions
• Detailed technical parameters of the CT scan
• Findings and impressions from the radiologist's interpretation
• Documentation that contrast was administered, including the type and amount
• Any adverse reactions or complications related to the procedure

The documentation must clearly establish why imaging of both regions was medically necessary and why contrast was required for diagnostic purposes.

When billing for CPT code 74177, it's important to document both the technical component (the actual performance of the CT scan) and the professional component (the interpretation of the images by a qualified physician). These components may be billed separately in hospital settings, while in outpatient imaging centers, they might be billed together.

CPT code 74177 billing guidelines

To ensure accurate billing with CPT code 74177, verify that:

• Both the abdomen and pelvis were imaged during the same session
• Contrast material was administered
• The examination was performed on the same patient, on the same day
• Medical necessity for the combined study is clearly established
• The appropriate code is selected based on the specific procedures performed

To accurately describe the imaging services provided, it's important to distinguish this code from similar codes, such as 74176 (without contrast) and 74178 (with and without contrast).

Understanding these variables is essential for optimizing the revenue cycle and ensuring appropriate reimbursement. Coverage criteria may also differ among local carriers and insurance providers, making verifying coverage before performing the procedure important.

Other relevant codes

When considering CT imaging of the abdomen and pelvis, it's important to be familiar with related CPT codes to ensure the most appropriate code selection:

• 74176: CT of abdomen and pelvis; without contrast material
• 74178: CT of abdomen and pelvis; with and without contrast material (combined)
• 74150: CT of abdomen; without contrast material
• 74160: CT of abdomen; with contrast material
• 74170: CT of abdomen; without contrast material, followed by contrast material(s) and further sections
• 72192: CT of pelvis; without contrast material
• 72193: CT of pelvis; with contrast material
• 72194: CT of pelvis; without contrast material, followed by contrast material(s) and further sections