Abdominal radiology ct urography has become the primary imaging modality for evaluation of hematuria, as well as in the staging and surveillance of urinary tract malignancies. If most of the xrays pass through a structure, it appears black such as airfilled lungs. I would like to know if anyone has had experience with ct urogram for surveillance not. Pyelography is frequently used to localize and diagnose disorders of the urinary tract such as kidney stones icd9 code 592. No fee schedules, basic units, relative values or related listings are included in the cpt book. Choose modality o ct o fluoroscopy o mri o ultrasound o mg decision tree 2. Ct urography ctu or ctivu has now largely replaced traditional ivu in imaging the genitourinary tract. This allows accurate visualization of the kidneys, ureters, bladder, and urethra, which in turn allows a more accurate diagnosis of urinary conditions such as stones, blockages, kidney. Im not sure if this is a correct strategy and would like to get a grasp of these codes. To prospectively compare the diagnostic performance and the visualization of the upper urinary tract uut using a comprehensive 3. Technique is abdomenpelvis with and without contrast with pyelogramkub. Definition and purpose of cpt cpt codes are a list of descriptive terms, guidelines, and identifying codes for reporting medical services and procedures.
What is the current role of ct urography and mr urography. Urography is also often performed using computed tomography ct or magnetic resonance imaging mri. In fact, intravenous urography was used for a large variety of indications, including for patients with frequent urinary tract infections. A ct scan works on nearly the same principles as an xray scanning technique. Urogram 74178 please authorize all codes listed for that study. Ct urography is defined as ct examination of the kidneys, ureters and bladder with at least one series of images acquired during the excretory phase after intravenous contrast administration. You will be changing into a medical gown for your exam. Wear comfortable clothing that is easy to get in and out of. A single authorization for cpt codes 70486, 70487, 70488, or 76380.
The american urologic association and national comprehensive cancer network nccn guidelines recommend a contrastenhanced computed tomography ct of the abdomen and pelvis with excretory phase known as ct urography or magnetic resonance mr urography for the staging of mibc raisbahrami et al. Does a ct urogram with contrast highlight the abdominal and pelvic organs as well as an abdominal and pelvic ct scan answered by a verified doctor we use cookies to give you the best possible experience on our website. Hematuria and ct imaging of urinary tract multidetector ct urography is a first line. You will have to remove all metal before getting in the the ct scanner. Ct exam cpt code reference use this reference to quickly determine the correct exam for your patients based on the indications described herein and the cpt for the order.
It gives both anatomical and functional information, albeit with a relatively higher dose of radiation. 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. Also, my tumor was right where the ureter leads into the bladder. The main reason for a computerized tomography ct urogram is to do an examination of the kidneys, ureters, and bladder.
If not available, you can schedule the patient at wr garner, wr chapel hill or. Magnetic resonance angiography, ct enteroclysis, barium enema, ct enterography with contrast iv and 3d reconstruction. Ct urography ctu and mr urography mru are used as primary imaging techniques to evaluate patients with blood in the urine hematuria, follow patients with prior history of cancers of the urinary collecting system and to identify abnormalities in patients with recurrent urinary tract infections. Ct urography is a rapidly evolving technique made possible by recent advances in ct technology.
Ct abdomen abdominal ct with contrast cpt 74160 or without. Diagnostic performance and visualization scores of 3. Petct radiology mra 2019 radiology cpt codes ct cta bone densitometry mri nuclear medicine phone. A ct scan uses xrays to take detailed pictures of your body from different angles. These cpt codes represent the most commonly ordered ct exams.
The aim is to illustrate the collecting systems, ureters and bladder with intravenous contrast, albeit in a single acquisition as opposed to the multiple and more dynamic traditional ivu. Xrays, produced by a machine, either pass through or are deflected by parts of the body. Sir advisor honored at ama cpt editorial panel meeting ama issues coding guidance. Bladder cancer detection with ct urography in an academic. Does a ct urogram with contrast highlight the abdominal. Ct urogram bladder cancer discussion forum bladder. Technique is abdomenpelvis with and without contrast with. Please include creatinine levels for patients over 60 or with history of renal failure. You should also report 51600 injection procedure for cystography or voiding urethrocystography for the instillation of. Ct urography includes a noncontrast phase and contrastenhanced nephrographic and excretory delayed phases. 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. Ct urography uses xrays to generate multiple images of a slice of the area in your body being studied, including bones.
A computerized tomography ct urogram is an imaging exam used to evaluate your. I questioned my urologist and he said almost all ct scans show this in the liver due to newer scan technologies. A major advantage of ct is its ability to image bone, soft tissues and blood vessels all at the same time. If you are diabetic and on glucophage, metformin or glucovance or allergic to iodine, please call our office for instructions. Magnetic resonance elastography, ct scan, ctguided biopsy, barium swallow study, ultrasoundguided fine needle aspiration, ct urogram. Ct abdomen with contrast cpt 74160 or without and with contrast cpt. Ct abdomen and pelvis without contrast cpt 74176 or ct urogram cpt. Intravenous urography was developed in the 1920s and became the mainstay of upper tract imaging for most of the 20th century. Mr urography vs ct urography the safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Listing a study does not mean it has been evaluated by the u. For pulmonary masses 3cm or hilar enlargement use chest ct with contrast routine protocol scan comments. As a general rule, urography is an outpatient procedure. It is used in diagnostic testing for various conditions related to the urinary tract and is also used to follow up on treatment for conditions like kidney stones and cancers of the urinary tract. Wiki radiology ct urogram medical billing and coding.
Ct scanning ct protocols ctisus ct scan, protocols. Radiology ordering guide cover radiology associates. Smil performs ct urography after intravenous contrast material is used to obtain images of the urinary tract. This exam has been introduced to replace or complement the ivp or excretory urogram. Urography with conventional xray is known as intravenous pyelogram ivp. Use this reference to quickly determine the correct exam. However, the accuracy of ct urography was considerably lower in patients with a prior urothelial malignancy 78%, 123 of 158. In a hospital where the urologist interprets only the ct study, append modifier 26 professional component to 72192 or 72193. Show more areas of focus for kumar sandrasegaran, m. Ct scan protocols, ct protocols by manufacturer ge, siemens, phillips, toshiba.
Slice counts dual source, 320 slice, 256 slice, 128 slice, 64 slice, 16 slice, 4. It has been suggested that since my initial tumor was grade 3 that i have a ct urogram in addition to my first 12month followup cysto. A computer then puts them together to make a 3 dimensional 3d image. The npv of ct urography was higher in patients evaluated for hematuria alone 98%, 589 of 603. Unlike conventional xrays, ct scanning provides very detailed images of many types of tissue as well as the lungs, bones, and blood vessels.
A ct urogram is a test using a ct scan and special dye contrast medium to look at the urinary system. A urogram is a radiograph, or xray image, of the urinary tract, and the process of making one is known as urography. Please do not eat or drink anything for 4 hours prior to your exam. It allows your doctor see the size and shape of these structures in order to determine if they are working normally and to look for signs of. Ct scan preparation urogram preparation instructions. 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 is an accurate noninvasive test for detecting bladder cancer in patients at risk for the disease. Used as an effective communication among physicians. 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. Choosing the correct code from urography series optimizes.
Prior to 2011, computed tomography ct of the abdomen and ct of the pelvis could be reported, and were reimbursed, separately. Ct scan preparation urogram procedure preparation md. Acr radiology coding source american college of radiology. The purpose of cpt is to provide a uniform language that describes medical, surgical, and diagnostic services. Radiology ordering guide this guide is to help you order the correct imaging study. In most cases, my coders fall back to 74400 urography pyelography, intravenous, with or without kub, with or without tomography. The contrast medium helps show up the urinary system more clearly. Please arrive 30 minutes before your scheduled appointment time. These cpt codes represent the most commonly ordered mri exams.