A comparison of noncontrast ct and intravenous urography. It includes indications and recommendations to consider as well as cpt codes to use. I am scheduled for a cystoscopy in the urologists office on 93. However, usually if a doctor wants to evaluate the prostate, they will not get a ct, but an ultrasound or a mri. Computed tomography ct exam to order symptomsconcerns cpt code ct angiography chest aneurysm ascending aorta or aortic. Chest, abdomen and pelvis ct protocols chest chest ct low dose nodule evaluation chest ct lung cancer screening chest ct routine with contrast chest ct without routine chest cta pulmonary embolism chest cta acute aorta chest cta aortic aneurysm pre evt chest cta aortic aneurysm post evt chest cta acute aorta trauma chest ct high resolution. You may be given a gown to wear during the procedure. For routine fu thoracic aneurysm noncontrast not needed. Chest, abdomen and pelvis ct protocols chest chest ct low dose nodule evaluation chest ct lung cancer screening chest ct routine with contrast. Category i codes are used for billing and recording purposes category ii codes are used in research and tracking 7. Unlike conventional xrays, ct scanning provides very detailed images of many types of tissue as well as the lungs, bones, and blood vessels. A summary document was produced and discussed at the esur 2006 and ecr 2007 meetings with the.
Ct urogram procedure doctor answers on healthcaremagic. Kub cannot visualize radiolucent calculi 1020% of calculi and overlying bowel gas, faecoliths, and phleboliths can make interpretation difficult 25. After my family doc treated me with antibiotics thinking this might be caused by uti, things didnt change at all. I had blood tests which did not show anything wrong with kidney function. Feb 23, 2012 ive been referred for a ct urogram with and without contrast for a bladder wash that came back with atypical cells. In children, ultrasound cpt 76770 or cpt 76775 or mr urography mri. Costeffectiveness of common diagnostic approaches for. Ct colonography ct enterography ct urogram ct urogram low dose renal mass renal cta retroperitoneal hemorrhage oncology. Painless hematuria, known or suspected tumor in bladder, ureter or renal collecting systems. My husband has to have a ct urogram, will this show the. Virtual colonoscopy w 74262 wo 74261 calcium score selfpay wo 75571 chest w 71260 wo 71250 wwo 71270 cta chest angiogram 71275 chest low dose screen g0297 abdomen w 74160 wo 74150 wwo 74170 cta abdomen. Ct urogram guideline the medford radiological group. Urography with conventional xray is known as intravenous pyelogram ivp. You will be asked to undress for this test and to remove any jewelry andor piercings from this area.
It includes indications and recommendations to consider as well as cpt codes to use when ordering the appropriate tests. Please note that the exam times do not include time needed for patient registration, changing clothes or contrast administration. Employing these guidelines helps providers enhance quality of care and contribute to the most efficacious use of radiology. This test is a specialized xray of your organs located between the lower lungs and bottom of your pelvis. Breaking down the cpt book the cpt book is broken down into 8 sections of the category 1 codes. Mar 24, 2016 how does a person prepare for a ct urogram. Payment reduction for computed tomography ct diagnostic imaging beginning in 2016, claims for ct scans described by related cpt codes that are. Wake radiology cpt codes and exam times wr provider portal. A major advantage of ct is its ability to image bone, soft tissue and blood vessels all at the same time. Creation of cpt american medical association created cpt in 1966 1st edition contained primarily surgical codes it began as a 4 digit system but in 1970 changed to 5 digits in 2000, cpt was named the national standard under. Although cpt 74410 urography, infusion, drip technique andor bolus technique and 74415 with nephrotomography remain valid codes and may continue to be assigned, many experts anticipate that they will be eliminated when cpt 5 is published. Pama appropriate use criteria are you prepared for rac audits in 2020. During the study period january2014 through december2015, all consecutive patients in our tertiary university hospital scheduled by a urologist for ctu to exclude uut malignancy were invited to participate.
Manual on contrast media reports that studies show the amount of contrast. Wear comfortable clothing that is easy to get in and out of. Metal objects including jewelry, eyeglasses, dentures and hairpins may affect the ct images and should be left at home or removed prior to your exam. If your physician has ordered a ct urogram exam, you should wear comfortable, loosefitting clothing to your exam. A summary document was produced and discussed at the esur 2006 and ecr 2007 meetings with the goal to reach consensus. Your preparation may vary depending on whether your exam will use ct or mri. Radiology ordering guide this guide is to help you order the correct imaging study. Imaging of the urinary tract is pivotal in the diagnosis, management, and followup of patients with urolithiasis. A computerized tomography ct urogram is an imaging exam used to evaluate your urinary tract, including your kidneys, your bladder and the tubes ureters that carry urine from your kidneys to your bladder.
Radiology ordering guide cover radiology associates. The model was programmed in treeage pro version 2015, treeage. This comprehensive guide to imaging services was developed to help in prescribing and ordering the correct testing for your patients. Ct urogram transitional cell carcinoma of ct abdomen and pelvis 74178 kidneys bladder. These cpt codes represent the most commonly ordered mri exams. What is aan ct urogram abdomen and pelvis combined. Choosing the correct code from urography series optimizes. Generally the test will go down far enough to visualize the prostate as well. Ct kub or stone protocol ct is now the firstline imaging investigation in the diagnosis of calculus disease with a reported sensitivity of 96% to 100%.
Abdominal ct without contrast cpt74150 or abdomen and. Ct scan cat scan, computerized tomography imaging procedure. Ive been referred for a ct urogram with and without contrast for a bladder wash that came back with atypical cells. Acr radiology coding source american college of radiology. Mine was cancer but if i had gotten relaxed with ct urogram findings i might have delayed more testing. My concern is the radiation level is supposed to be very high and in the past 3 months ive had a mammogram, abdominal xray, abdominal ct with contrast and xrays done during ercp and cholesectomy. Cms releases guidance for understanding revised lcd procedures. Cpt 2017 evaluation and management office or other outpatient services 9920199203 j. Is the ct urogram enough to exlude a bladder tumor or should i also carry out a cytoscopy.
For any coding inquiry not listed please call us at 860 5253322. A ct scan or computed tomography scan formerly computerized axial tomography scan or cat scan makes use of computerprocessed combinations of many xray measurements taken from different angles to produce crosssectional tomographic images virtual slices of specific areas of a scanned object, allowing the user to see inside the object without cutting. Cpt code pelvis fracture ct pelvis 72192 nonunion without contrast prostate treatment planning arthritis ct pelvis 72193 cancer staging with contrast mass cysts pain infection abscess bone infection ct pelvis 72194 recommend mri without and with contrast ct urogram transitional cell carcinoma of ct abdomen and pelvis 74178. The ct scanner is a large machine that is shaped like a donut. The use of ultrasound in lieu of ct as the firstline diagnostic strategy will optimize. Choose modality o ct o fluoroscopy o mri o ultrasound o mg decision tree 2.
Ct urography is a sophisticated, specialized radiological examination designed to evaluate the urinary tract kidneys, ureters and bladder using computed tomography ct. Smil performs ct urography after intravenous contrast material is used to obtain images of the urinary tract. Oct 22, 2017 urography is a radiologic technique used for the evaluation of the genitourinary systemspecifically, the kidneys, ureters, and bladder. If you are enrolled in champva, you dont need to take additional steps to meet the health care law coverage standards. Prior to 2011, computed tomography ct of the abdomen and ct of the pelvis could be reported, and were reimbursed, separately. Mri and ct cpt coding guide diagnostic imaging services. Pyelography is frequently used to localize and diagnose disorders of the urinary tract such as kidney stones icd9 code 592. You will have to remove all metal before getting in the the ct scanner. Ct abdomen abdominal ct with contrast cpt 74160 or without and with. These cpt codes represent the most commonly ordered ct exams. Ct and mr urography are painless and proven effective in detecting urinary tract issues. Although originally performed using plain radiographic techniques, advanced imaging modalities have been progressively refined such that computed tomography ct andor magnetic resonance imaging mri have largely replaced excretory urography eu as the. This exam has been introduced to replace or complement the ivp or excretory urogram.
Consider getting radiologist input if requested on patients under 50, especially. My urogram was pretty much normal, it showed some cysts in the kidney. A comparison of noncontrast ct and intravenous urography in. I have ct urogram scheduled in two weeks after ive been trying to find out why am i having both visible blood in urine and even when i thought it went away, urine analysis still detected occult blood in my urine. I realize the retrograde pyelogram is much more invasive, however, which is the best test for detecting possible cancer in. The health care law does not change champva benefits or outofpocket costs. Urography images are used to evaluate issues or detect abnormalities in portions of the urinary tract, including the kidneys, bladder and ureters, including. Ct urography uses xrays to generate multiple images of a slice of the area in your body being studied, including bones. Consider getting radiologist input if requested on patients under 50, especially if patient is female, and especially if requested by a provider other. The ct urogram is a test that looks at the kidneys, bladder, and ureters. If your physician has ordered a ct urography exam, you should wear. Hello, i had gross hematuria red urine a few weeks ago, with no pain, which lasted 4 days. I realize the retrograde pyelogram is much more invasive, however, which is the best test for detecting possible cancer in the ureter.
Urography urography uses imaging and contrast material to evaluate or detect blood in urine, kidney or bladder stones, and cancer in the urinary tract. The aim was to develop clinical guidelines for multidetector computed tomography urography ctu by a group of experts from the european society of urogenital radiology esur. Urogram wwo 74178 ct angio wwo 74174 ct enterography 74177 abd wopelvis wo 74176. Physician cpt code desktop reference radiology diagnostic center 10 las tablas road, ste 103 templeton. Acr presents four code families at the april 2019 ruc meeting. Mar 22, 2019 benefits and risks ct urography benefits. Brain mra brain w 70552 wo 70551 wwo 70553 mra brain angiogram 70544 orbits face pituitary, iac, tmj w 70542 wo 70540 wwo 70543 tmj wo 70336 neck soft tissue w 70542 wo 70540 wwo 70543. For any coding inquiry not listed please call us at 860 9696400. Octo ber 2015 december 2015 all liver ct with imaging features of cirrhosis n 31. I have had a lot of blood in the urine, visible to the eye. Ct urography if your physician has ordered a ct urography exam, you should wear comfortable, loosefitting clothing to your exam. Hematuria and ct imaging of urinary tract multidetector ct urography is a first line of investigation. The acr appropriateness criteria ac are evidencebased guidelines to assist referring physicians and other providers in making the most appropriate imaging or treatment decision for a specific clinical condition.
Wake radiology cpt codes and exam times wr provider. January 2015 september 2015 all liver ct with imaging features of cirrhosis n 49 second cycle modified protocol group. Ct urogram in utah, learn how to prepare mountain medical. Diagnostic performance and visualization scores of 3. Nov 10, 2009 no, a ct scan is basically a form of xray though you may have an injection of dye into your veins just before the scan. Ct is not the best type of imaging study to look at the prostate gland. See section 3 for the number of the servicing center for your state. Acr submits comments on apc placement of new cpt codes. Ive been referred for a ct urogram with and without. Acr presents three code proposals at ama cpt editorial panel meeting. Do normal ct urogram results mean there is absolutely no cancer. This provides cpt codes and exam times for procedures wake radiology performed in our outpatient imaging offices.
You may also need a scope in your penis cystoscopy at some stage in the investigations so the doctor can look inside your urinary tract, prostate and bladder but dont worry about that it is painless just a little uncomfortable. A computerized tomography ct urogram is an imaging exam used to evaluate your. Cpt code and nuclear medicine procedure descriptions cpt code and petct procedure descriptions wake radiology has been a lowdose leader in the triangle, adopting rigorous ct dose compliance and quality control standards for our outpatient facilities that go above and beyond the standards set by the acr. An intravenous needle iv will be inserted in your arm. Computed tomographic urography alone has been advocated on the. I dont know much about any of this and the web makes it sound like a ct urogram is a tell all.
Urography is also often performed using computed tomography ct or magnetic resonance imaging mri. You will be asked to lie on your back on the scanning table with your arms placed above your head. Historically, urologists have used a variety of imaging modalities, including plain radiography of the kidneys, ureters and bladder kub, ivu, ultrasound us, magnetic resonance urography mru and computed tomography ct, each with its. You see, most insurance providers, including medicare, allow hospitals to charge more than outpatient centers. But we negotiate lower rates with these providers, so our patients typically pay less than they would if they went to a hospital. You will be changing into a medical gown for your exam. Before scheduling your test, please tell your provider. Acr appropriateness criteria american college of radiology. Ct abdomen with contrast cpt 74160 or without and with. For acute chest pain with specific history of ro dissection include noncontrast ct to evaluate for acute intramural hematoma. Computerized or computed tomography, and often formerly referred to as computerized axial tomography cat scan, is an xray procedure that combines many xray images with the aid of a computer to generate crosssectional views and, if needed, threedimensional images of the internal organs and structures of the body. A single authorization for cpt codes 70486, 70487, 70488, or 76380. Historically, urologists have used a variety of imaging modalities, including plain radiography of the kidneys, ureters and bladder kub, ivu, ultrasound us, magnetic resonance urography mru and computed tomography ct, each with its advantages and limitations. East 18662297389 west 18883850235 refill system 18883701699.