Coding for CTs of the pancreas and pelvis with and without contrast

Q.

A physician ordered a CT of the pancreas without and with contrast, and a CT of the pelvis without and with contrast. Is this documentation sufficient to allow us to submit CPT^® code 74178? 

A.

Yes, there is no CPT code for CT pancreas, it’s part of a CT abdomen, and since you also had an order for and did a CT pelvis, you would assign the bundled CPT code, 74178. Narrative instructions in the CPT manual for CPT codes for CTs and MRIs do not state required elements (as in US exams). They should be tailored to the patient, so a “complete” abdominal CT is not necessary to submit CPT code 74178 as long as you also perform a CT pelvis.