Health Information Management

Bill 70470 for CT scan without, then with contrast

APCs Insider, June 10, 2005

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Bill 70470 for CT scan without, then with contrast

Q: Our facility performs a CT scan of the head without contrast (CPT 70450) on a patient, then later that day performs a second CT scan on the same patient but this time with contrast (CPT 70460). Our question is, are these two CPT codes billable the same day? Should we report these codes together with a modifier in order to receive payment for both procedures?

A: Procedure code 70470 describes a CT procedure without contrast followed by a CT procedure with contrast. This is the correct CPT code to report in the scenario you have described.

The Correct Coding Initiative has an edit on 70450 and 70460 when these codes are reported together. It prevents separate payment and you cannot bypass this edit with a modifier.

Therefore, you will need to credit off both the 70450 and the 70460 on the patient's account and add a single charge of 70470. CPT 70470 maps to APC 0333 with a national payment rate of $320.39.



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