February 28, 2003

ACR Radiology Coding Source™ January-February 2003 Q and A

Q: What is the correct CPT® radiology code to describe an ultrasound of a pregnant uterus with multiple gestations when no maternal evaluation is provided?

A: It is the consensus of the ACR's Committee on Coding & Nomenclature that if an ultrasound of a pregnant uterus with multiple gestations is performed without maternal evaluation, it would be appropriate to code either 76801 for the first gestation and 76802 for each additional gestation if performed during the first trimester (< 14 weeks 0 days), or 76805 for the first gestation and 76810 for each additional gestation if performed after the first trimester (= or > 14 weeks 0 days) as long as reason for nonvisualization is documented. As noted in the introductory notes of the CPT® 2003 Manual, all elements must be evaluated and documented in the report or the reason for non-visualization.

Q: How do you code for treatment aids using multi-leaf collimation (MLC) when it substitutes for the use of blocks? Would you code one treatment aid charge for each gantry angle?

A: It is appropriate to report one treatment device code per (77332-77334) gantry angle.

Q: How should a CT virtual colonoscopy be coded?

A: It is the opinion of the ACR's Committee on Coding & Nomenclature that CT of the abdomen, CT of the pelvis and 3-D reconstruction (76375) codes are appropriate to describe a fly-through exam of the colon (sometimes called "virtual colonoscopy").
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