Computed Tomography or CT exam are very frequently done in radiology. CT exams are very helpful in diagnosing harmful diseases or disorder. In Radiology, we have already learnt about coding chest x-ray, MRI CPT codes, Ultrasound exam etc. so now we focus on coding CT exam. As a coder, many of us have a confusion about coding CT exam and CTA (Computed Tomography Angiography). There is a very big difference between these two exams. If you are clear with the use of these codes, it will really benefit you for preparing for medical coding certification exam. The CPT codes used are different based on the site examined. Let us check more about them.
Main Difference between CT and CTA exam
CTA are used for finding diagnosis in the blood vessel (angiography). CPT code for Angiography are always high paid procedure and procedure are also little complex. For example, the CTA exam of chest is always done with use of three-dimensional (3D) or MIP (Maximum Intensity Projection) images to find pulmonary embolism in the arteries. Use of 3D or MIP images is mandatory for any CTA exam, if not we have query the physician. CT are exam is not focused on blood vessels, they are used for diagnosing other disorders like pleural effusion, atelectasis, pneumonia, neoplasm etc. For CTA exam, do not report any primary diagnosis other than related to blood vessel it can be denied from the payers. CTA exam are mainly for finding occlusion or thrombosis in the blood vessel and hence the diagnosis code should be from this category. CT exams are done for wide range of disorders.
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Difference between CT and CTA exam
Let use check this procedure with an example. We know about CT Chest and CTA chest exam. There is only one CPT code for CTA chest exam while we have three CPT codes for CT chest exam. Below are the CPT codes used for CT and CTA chest exam.
71250 – CT chest without contrast (oral contrast are considered without contrast)
71260 – CT chest with contrast (only IV contrast is considered with contrast)
71270 – CT chest with and without contrast
71275 – CTA chest without and with contrast.
As you can see above the CPT codes, you can easily differentiate on thing, the use of contrast. CTA exam is done only without and with contrast, there is no other way the exam is performed. For CT chest, we straight away have three CPT codes depending on the use of Contrast. Do always remember only IV (intravenous) contrast are considered as with contrast exam, while Oral contrast are considered as without contrast exam. So, if a CT chest exam is performed with oral contrast, we will use only 71250 CPT code not 71260.
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One more example for CT and CTA exam for Abdomen and Pelvis
74176 – CT Abdomen Pelvis without contrast
74177 – CT abdomen Pelvis with contrast
74178 – CT abdomen Pelvis without and with contrast
74175 – CTA Abdomen Pelvis without and with contrast
Just remember, we do not use separate CPT code for abdomen and pelvis when we have a combined code for both. So, if an exam is performed on both abdomen and pelvis do use a combined CPT code from above list for CT and CTA exam.