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Coding for CT colonography for diagnosis and screening

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Q.

Do you have information on billing, coding, and reimbursement for Virtual Colonoscopy / CT Colonography / CTC?

A.

There are three possible CPT® codes available for CT Colonography

  • 74261 Computed tomographic (CT) colonography, diagnostic, including image post processing; without contrast material
  • 74262 Computed tomographic (CT) colonography, diagnostic, including image post processing; with contrast material(s) including non-contrast images, if performed
  • 74263 Computed tomographic (CT) colonography, screening, including image post processing

As of 2021, the USPSTF has lowered their guidelines to begin screening for Colorectal Cancer at age 45 instead of 50. While Medicare only covers CTC for screening, many commercial payors will cover CTC as a diagnostic and screening exam. For more information on CTC coverage, please visit www.myctcolonography.com