When do you order a CT abdomen/pelvis with contrast or without contrast. When do you order a CT abdoment and pelvis together?
These are common questions radiologists get daily.
First year radiology residents: Review this guide because it will help you decide which protocol to use when a technician calls into the reading room during your Body rotation.
This is a helpful primer for non-radiologist physicians (i.e. family practice, internal medicine, surgeons, etc) on when to order a CT Abdomen with a CT Pelvis for common indications/symptoms. Plus, it discusses which indications require IV and Oral Contrast. This will be helpful for other ordering clinicians such a Nurse Practitioners (NPs) and Physician Assistants (PA).
When to Order a CT Abdomen AND CT Pelvis TOGETHER
|
||
CT Abdomen / Pelvis WITHOUT IV CONTRAST
|
CT Abdomen / Pelvis
WITH IV CONTRAST
|
CT Abdomen / Pelvis
W & WITHOUT IV CONTRAST
|
CPT
74176
|
CPT
74177
|
CPT
74178
|
Order when evaluating
for:
|
Order when evaluating for:
|
Order when evaluating
for:
|
·
Hematuria
/ STONE STUDY
|
·
Abdominal
Pain (upper and lower quadrants)
·
Inflammatory
Bowel Disease (including Crohns,
Ulcerative Colitis)
·
Appendicitis
·
Abscess
·
Hernia
(ventral, umbilical, inguinal)
·
CT
Enterography
|
·
Cyst
vs Mass (kidney)
·
Painless
Hematuria
·
Transitional
Cell Carcinoma of Kidney
·
CT
Renal Mass
·
CT
Urogram
|
Please Note – In 2011 the AMA COMBINED the CT Abdomen CT Pelvis CPT Codes
into singular combined CPT Codes (74176, 74177, and 74178). Although the individual studies for a
single CT Abdomen and CT Pelvis still exist, the above codes are designed to
capture those cases where the codes (pre 2011) would have been billed
together.
When to Order a CT Abdomen ONLY
|
||
CT Abdomen
WITHOUT IV CONTRAST
|
CT Abdomen
WITH IV CONTRAST
|
CT Abdomen
W & WITHOUT IV CONTRAST
|
CPT
74150
|
CPT
74160
|
CPT
74170
|
Order when evaluating
for:
|
Order when evaluating
for:
|
Order when evaluating
for:
|
·
Follow
up for patients with Renal Cell Carcinoma in Renal Failure (recommend MRI)
|
·
Epigastric
issues / evaluation
·
RUQ
Pain
·
LUQ
Pain
·
Pseudocyst
|
·
Pancreatitis
·
Pancreas
Mass
·
Liver
Mass
·
Adrenal
Protocol
·
CT
Dual Phase Liver - Hepatic
Protocol
·
CT
Pancreas (Pancreatic Protocol)
|
NOTE - The UHS Protocol for a CT Abdomen covers from the diaphragm dome (Xiphoid
Process) to iliac crests (Belly Button).
When to Order a CT Pelvis ONLY
|
||
CT Pelvis
WITHOUT IV CONTRAST
|
CT Pelvis
WITH IV CONTRAST
|
CT Pelvis
W & WITHOUT IV CONTRAST
|
CPT
72192
|
CPT
72193
|
CPT
72194
|
Order when evaluating
for:
|
Order when evaluating
for:
|
Order when evaluating
for:
|
·
Prostate
Treatment Planning (Pubic Arch Study Protocol)
|
·
Cancer
Staging
·
Mass
in pelvic region*
·
Cysts
in pelvic region*
·
Pain
in pelvic region*
·
Infection
in pelvic region*
|
*The Pelvic Region as defined by Medicare is the “lower abdomen.” The UHS Protocol for a CT Pelvis covers
from the Iliac crest (Belly Button) through Ischial Tuberosities (Upper Thigh)
Source:M.Langenberg 2014
For ordering physicians and patients, this should be helpful information when ordering CT scans ("cat scans").
Hope this helps answer some questions about when you order a CT abdomen/pelvis with contrast or without contrast.
For ordering physicians and patients, this should be helpful information when ordering CT scans ("cat scans").
Hope this helps answer some questions about when you order a CT abdomen/pelvis with contrast or without contrast.
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