Understanding Upper Extremity CT Coding

Upper extremity coding for computed tomography carries serval distinct codes worth noting. Coding for this scenario requires some basic understanding of the nuances and rationale

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Radiology Question for the Week of October 17, 2022

Usually, we instruct coders that if three-dimensional (3D) reconstruction of images is not described in the medical report, it is appropriate to code for a CT study and not a CTA study. This situation most often arises when physicians dictate notes following a CT of the chest for pulmonary embolism. Often physicians identify such a study as a CTA because during the study they are looking at vessels, but such a study is not really a CTA for coding purposes. When coding a CTA of the abdominal aorta with runoffs (code 75635), if the coder does not see a dictation specifying that a 3D postprocessing technique was used, should the coder code for a CT of the abdomen with contrast, a CT of the right leg with contrast, and a CT of the left leg with contrast? The 3D requirement for a CTA study when coding abdomen with runoff creates an issue if the physician does not document a 3D postprocessing technique.

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Radiology Question for the Week of October 3, 2022

CT of the head without contrast is performed in the morning, and a CT of the head with contrast is performed on the same day in the afternoon. Is it correct to code this scenario using 70450 with 70460 separately accompanied by modifier 59, or choose just 70470?

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