Tuesday, March 21, 2017

CT abd CPT CODES 74176- 74178


CPT/HCPCS Codes

Group 1 Codes:
72192 Ct pelvis w/o dye
72193 Ct pelvis w/dye
72194 Ct pelvis w/o & w/dye
74150 Ct abdomen w/o dye
74160 Ct abdomen w/dye
74170 Ct abdomen w/o & w/dye
74176 Ct abd & pelvis w/o contrast
74177 Ct abd & pelv w/contrast
74178 Ct abd & pelv 1/> regns

Coverage Indications, Limitations, and/or Medical Necessity

Indications

Evaluation of abdominal or pelvic pain.

Evaluation of known or suspected abdominal or pelvic masses or fluid collections, primary or metastatic malignancies, abdominal or pelvic inflammatory processes, and abnormalities of abdominal or pelvic vascular structures.

Evaluation of abdominal or pelvic trauma.

Clarification of findings from other imaging studies or laboratory abnormalities.

Evaluation of known or suspected congenital abnormalities of abdominal or pelvic organs.

Treatment planning for radiation therapy.

Limitations

Three dimension reconstruction of CT of Abdomen and Pelvis (CPT code 76376 or 76377) is not expected to be utilized routinely. CPT code 76376 or 76377 are not an appropriate part of every CT examination.


Bill Type Codes:

Contractors may specify Bill Types to help providers identify those Bill Types typically used to report this service. Absence of a Bill Type does not guarantee that the policy does not apply to that Bill Type. Complete absence of all Bill Types indicates that coverage is not influenced by Bill Type and the policy should be assumed to apply equally to all claims.
999x Not Applicable

Revenue Codes:

Contractors may specify Revenue Codes to help providers identify those Revenue Codes typically used to report this service. In most instances Revenue Codes are purely advisory. Unless specified in the policy, services reported under other Revenue Codes are equally subject to this coverage determination. Complete absence of all Revenue Codes indicates that coverage is not influenced by Revenue Code and the policy should be assumed to apply equally to all Revenue Codes.

99999 Not Applicable



ICD-10 Codes that Support Medical Necessity


ICD-10 CODE DESCRIPTION

A06.2 - A06.6 - Opens in a new window Amebic nondysenteric colitis - Amebic brain abscess
A06.81 - A06.89 - Opens in a new window Amebic cystitis - Other amebic infections
A18.10 - A18.18 - Opens in a new window Tuberculosis of genitourinary system, unspecified - Tuberculosis of other female genital organs
A18.31 - A18.39 - Opens in a new window Tuberculous peritonitis - Retroperitoneal tuberculosis
A18.7 Tuberculosis of adrenal glands
A18.83 Tuberculosis of digestive tract organs, not elsewhere classified
A18.85 Tuberculosis of spleen
A31.0 Pulmonary mycobacterial infection
A31.2 Disseminated mycobacterium avium-intracellulare complex (DMAC)
A34 Obstetrical tetanus
A39.1 Waterhouse-Friderichsen syndrome
A40.0 - A41.9 - Opens in a new window Sepsis due to streptococcus, group A - Sepsis, unspecified organism
A42.7 Actinomycotic sepsis
A50.04 Early congenital syphilitic pneumonia
A50.06 - A50.09 - Opens in a new window Early cutaneous congenital syphilis - Other early congenital syphilis, symptomatic
A51.49 Other secondary syphilitic conditions
A52.74 - A52.75 - Opens in a new window Syphilis of liver and other viscera - Syphilis of kidney and ureter
A56.11 Chlamydial female pelvic inflammatory disease
B15.0 - B19.9 - Opens in a new window Hepatitis A with hepatic coma - Unspecified viral hepatitis without hepatic coma
B25.1 - B25.2 - Opens in a new window Cytomegaloviral hepatitis - Cytomegaloviral pancreatitis
B37.7 Candidal sepsis
B65.0 - B65.9 - Opens in a new window Schistosomiasis due to Schistosoma haematobium [urinary schistosomiasis] - Schistosomiasis, unspecified
B67.0 Echinococcus granulosus infection of liver
B67.5 Echinococcus multilocularis infection of liver
B67.8 - B67.99 - Opens in a new window Echinococcosis, unspecified, of liver - Other echinococcosis
C00.0 - C43.9 - Opens in a new window Malignant neoplasm of external upper lip - Malignant melanoma of skin, unspecified
C4A.0 - C4A.9 - Opens in a new window Merkel cell carcinoma of lip - Merkel cell carcinoma, unspecified
C44.00 - C49.9 - Opens in a new window Unspecified malignant neoplasm of skin of lip - Malignant neoplasm of connective and soft tissue, unspecified
C50.011 - C75.9 - Opens in a new window Malignant neoplasm of nipple and areola, right female breast - Malignant neoplasm of endocrine gland, unspecified
C7A.00 - C7B.8 - Opens in a new window Malignant carcinoid tumor of unspecified site - Other secondary neuroendocrine tumors
C76.0 - C79.9 - Opens in a new window Malignant neoplasm of head, face and neck - Secondary malignant neoplasm of unspecified site
C80.0 - C84.79 - Opens in a new window Disseminated malignant neoplasm, unspecified - Anaplastic large cell lymphoma, ALK-negative, extranodal and solid organ sites
C84.A0 - C84.Z9 - Opens in a new window Cutaneous T-cell lymphoma, unspecified, unspecified site - Other mature T/NK-cell lymphomas, extranodal and solid organ sites
C84.90 - C84.99 - Opens in a new window Mature T/NK-cell lymphomas, unspecified, unspecified site - Mature T/NK-cell lymphomas, unspecified, extranodal and solid organ sites
C85.10 - C86.6 - Opens in a new window Unspecified B-cell lymphoma, unspecified site - Primary cutaneous CD30-positive T-cell proliferations
C88.2 - C91.62 - Opens in a new window Heavy chain disease - Prolymphocytic leukemia of T-cell type, in relapse
C91.A0 - C91.Z2 - Opens in a new window Mature B-cell leukemia Burkitt-type not having achieved remission - Other lymphoid leukemia, in relapse
C91.90 - C91.92 - Opens in a new window Lymphoid leukemia, unspecified not having achieved remission - Lymphoid leukemia, unspecified, in relapse
C92.00 - C92.62 - Opens in a new window Acute myeloblastic leukemia, not having achieved remission - Acute myeloid leukemia with 11q23-abnormality in relapse
C92.A0 - C92.Z2 - Opens in a new window Acute myeloid leukemia with multilineage dysplasia, not having achieved remission - Other myeloid leukemia, in relapse
C92.90 - C92.92 - Opens in a new window Myeloid leukemia, unspecified, not having achieved remission - Myeloid leukemia, unspecified in relapse
C93.00 - C93.32 - Opens in a new window Acute monoblastic/monocytic leukemia, not having achieved remission - Juvenile myelomonocytic leukemia, in relapse
C93.Z0 - C93.Z2 - Opens in a new window Other monocytic leukemia, not having achieved remission - Other monocytic leukemia, in relapse
C93.90 - C93.92 - Opens in a new window Monocytic leukemia, unspecified, not having achieved remission - Monocytic leukemia, unspecified in relapse
C94.00 - C94.32 - Opens in a new window Acute erythroid leukemia, not having achieved remission - Mast cell leukemia, in relapse
C94.80 - C96.4 - Opens in a new window Other specified leukemias not having achieved remission - Sarcoma of dendritic cells (accessory cells)
C96.A - C96.Z - Opens in a new window Histiocytic sarcoma - Other specified malignant neoplasms of lymphoid, hematopoietic and related tissue
C96.9 Malignant neoplasm of lymphoid, hematopoietic and related tissue, unspecified
D00.1 - D01.9 - Opens in a new window Carcinoma in situ of esophagus - Carcinoma in situ of digestive organ, unspecified
D03.0 - D03.9 - Opens in a new window Melanoma in situ of lip - Melanoma in situ, unspecified
D06.0 - D09.19 - Opens in a new window Carcinoma in situ of endocervix - Carcinoma in situ of other urinary organs
D12.0 - D12.9 - Opens in a new window Benign neoplasm of cecum - Benign neoplasm of anus and anal canal
D13.1 - D13.9 - Opens in a new window Benign neoplasm of stomach - Benign neoplasm of ill-defined sites within the digestive system
D16.8 Benign neoplasm of pelvic bones, sacrum and coccyx
D17.5 Benign lipomatous neoplasm of intra-abdominal organs
D17.71 Benign lipomatous neoplasm of kidney
D18.03 Hemangioma of intra-abdominal structures
D18.1 Lymphangioma, any site
D19.1 Benign neoplasm of mesothelial tissue of peritoneum
D20.0 - D20.1 - Opens in a new window Benign neoplasm of soft tissue of retroperitoneum - Benign neoplasm of soft tissue of peritoneum
D21.20 - D21.22 - Opens in a new window Benign neoplasm of connective and other soft tissue of unspecified lower limb, including hip - Benign neoplasm of connective and other soft tissue of left lower limb, including hip
D21.4 - D21.5 - Opens in a new window Benign neoplasm of connective and other soft tissue of abdomen - Benign neoplasm of connective and other soft tissue of pelvis
D25.0 - D28.9 - Opens in a new window Submucous leiomyoma of uterus - Benign neoplasm of female genital organ, unspecified
D30.00 - D30.9 - Opens in a new window Benign neoplasm of unspecified kidney - Benign neoplasm of urinary organ, unspecified
D35.00 - D35.02 - Opens in a new window Benign neoplasm of unspecified adrenal gland - Benign neoplasm of left adrenal gland
D35.6 Benign neoplasm of aortic body and other paraganglia
D3A.00 - D3A.8 - Opens in a new window Benign carcinoid tumor of unspecified site - Other benign neuroendocrine tumors
D37.1 - D37.9 - Opens in a new window Neoplasm of uncertain behavior of stomach - Neoplasm of uncertain behavior of digestive organ, unspecified
D39.0 - D39.9 - Opens in a new window Neoplasm of uncertain behavior of uterus - Neoplasm of uncertain behavior of female genital organ, unspecified
D40.0 - D41.9 - Opens in a new window Neoplasm of uncertain behavior of prostate - Neoplasm of uncertain behavior of unspecified urinary organ
D44.10 - D44.12 - Opens in a new window Neoplasm of uncertain behavior of unspecified adrenal gland - Neoplasm of uncertain behavior of left adrenal gland
D44.6 - D44.7 - Opens in a new window Neoplasm of uncertain behavior of carotid body - Neoplasm of uncertain behavior of aortic body and other paraganglia
D45 Polycythemia vera
D48.3 - D48.4 - Opens in a new window Neoplasm of uncertain behavior of retroperitoneum - Neoplasm of uncertain behavior of peritoneum
D49.0 Neoplasm of unspecified behavior of digestive system
D57.02 Hb-SS disease with splenic sequestration
D57.212 Sickle-cell/Hb-C disease with splenic sequestration
D57.412 Sickle-cell thalassemia with splenic sequestration
D57.812 Other sickle-cell disorders with splenic sequestration
D73.1 - D73.2 - Opens in a new window Hypersplenism - Chronic congestive splenomegaly
D73.81 Neutropenic splenomegaly
D75.0 - D75.1 - Opens in a new window Familial erythrocytosis - Secondary polycythemia
D78.01 - D78.22 - Opens in a new window Intraoperative hemorrhage and hematoma of the spleen complicating a procedure on the spleen - Postprocedural hemorrhage of the spleen following other procedure
D86.0 - D86.2 - Opens in a new window Sarcoidosis of lung - Sarcoidosis of lung with sarcoidosis of lymph nodes
D86.84 Sarcoid pyelonephritis
D86.89 - D86.9 - Opens in a new window Sarcoidosis of other sites - Sarcoidosis, unspecified
E08.51 - E08.52 - Opens in a new window Diabetes mellitus due to underlying condition with diabetic peripheral angiopathy without gangrene - Diabetes mellitus due to underlying condition with diabetic peripheral angiopathy with gangrene
E09.51 - E09.52 - Opens in a new window Drug or chemical induced diabetes mellitus with diabetic peripheral angiopathy without gangrene - Drug or chemical induced diabetes mellitus with diabetic peripheral angiopathy with gangrene
E10.51 - E10.52 - Opens in a new window Type 1 diabetes mellitus with diabetic peripheral angiopathy without gangrene - Type 1 diabetes mellitus with diabetic peripheral angiopathy with gangrene
E11.51 - E11.52 - Opens in a new window Type 2 diabetes mellitus with diabetic peripheral angiopathy without gangrene - Type 2 diabetes mellitus with diabetic peripheral angiopathy with gangrene
E13.51 - E13.52 - Opens in a new window Other specified diabetes mellitus with diabetic peripheral angiopathy without gangrene - Other specified diabetes mellitus with diabetic peripheral angiopathy with gangrene
E16.3 - E16.8 - Opens in a new window Increased secretion of glucagon - Other specified disorders of pancreatic internal secretion
E24.0 Pituitary-dependent Cushing's disease
E24.2 - E27.9 - Opens in a new window Drug-induced Cushing's syndrome - Disorder of adrenal gland, unspecified
E28.2 Polycystic ovarian syndrome
E35 - E36.12 - Opens in a new window Disorders of endocrine glands in diseases classified elsewhere - Accidental puncture and laceration of an endocrine system organ or structure during other procedure
E74.00 - E74.09 - Opens in a new window Glycogen storage disease, unspecified - Other glycogen storage disease
E83.10 - E83.19 - Opens in a new window Disorder of iron metabolism, unspecified - Other disorders of iron metabolism
E84.0 - E85.9 - Opens in a new window Cystic fibrosis with pulmonary manifestations - Amyloidosis, unspecified
E89.6 Postprocedural adrenocortical (-medullary) hypofunction

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