1. Chapter 16
CPT Radiology

2. Radiology Subsections
The following subsections are further divided into anatomic categories:
Diagnostic radiology imaging
Diagnostic ultrasound
Radiation oncology
Nuclear medicine

3. Diagnostic Imaging Subsection
Includes:
Noninvasive diagnostic and therapeutic procedures
Invasive diagnostic and therapeutic procedures
Computerized tomography (CT)
Magnetic resonance imaging (MRI)

4. Planes of View Coronal (frontal) Midsagittal Sagittal
Transverse (horizontal, axial)
(continued)

5. Planes of View
Planes that separate body structures (midsagittal, sagittal, coronal, and transverse)

6. Radiographic Projections
Anteroposterior projection
Lateral projection (side view)
Oblique projection
Posteroanterior (PA)

7. Radiographic Projections

8. Radiology Procedures Angiography Aortography Arthrography
Computed axial tomography (CT, CAT)
Computed tomography angiography (CTA)
(continued)

9. Radiology Procedures Nuclear imaging
Positron emission tomography (PET)
Single photon emission computerized tomography (SPECT)
Ultrasound (ultrasonography)
Venography
X-ray

10. Radiology Procedures
Cystography
Fluoroscopy
MRI

11. Contrast Medium Injection Device

12. Lateral Chest X-Ray
Bones of the spine are white; soft tissues are shades of gray

13. Abdominal CT Scan
Liver is predominant in upper-left; stomach is visible in upper-right

14. Fluoroscopy Unit
Dynamic radiographic examination that allows for visualization of flow of barium through gastrointestinal tract, injection of a contrast agent into the heart, etc.
Courtesy of GE Healthcare.

15. Computed Tomography Sections

16. 3D Computed Tomography Angiography Reconstructions
Carotid arteries
(continued)

17. 3D Computed Tomography Angiography Reconstructions
Coronary arteries

18. MRI
Includes stationary magnet, radio frequency coil, and gradient coils

19. MRI of the Brain
Courtesy of GE Healthcare

20. Key Terms Roentgen (R, r) Radiation absorbed dose (rad) Gray (gy)
Roentgen-equivalent-man (rem)

21. Radiology Procedures Three components: Modifiers: Technical component
Professional component
Global service
Modifiers:
-26 (professional component)
-TC (technical component)

22. Coding Tips
Modifier -50 (bilateral procedure) is not added to radiology procedures that are performed bilaterally because code descriptions often specify “bilateral.”
Modifier -51 (multiple procedures) is not usually added to radiology codes.
HCPCS level II anatomical modifiers -Lt and -Rt are added when appropriate.

23. “Complete”
Number of views required for study of a designated body part
Do not confuse use in the code description with use in a parenthetical note below a code

24. E/M Services Provided by Radiologist
No code reported when radiologist provides E/M services as part of radiographic procedure

25. Radiology Section Guidelines
Provide instruction about:
Subject listings
Separate procedures
Subsection information
Unlisted service or procedure
Special report
Supervision and interpretation
Administration of contrast material(s)
Written report(s)

26. Radiology Subsections
The following Radiology subsections contain notes unique to the subsection:
Diagnostic ultrasound
Radiation oncology
Nuclear medicine

27. Separate Procedures
Some procedures are considered an integral component of a total service or procedure and are identified by the descriptor “separate procedure.”

28. Special Report
When a service is new, unusual, or rarely provided, it requires a special report to validate the medical necessity and appropriateness of the service (e.g., complexity of symptoms).

29. Component Coding
Allows for reporting a radiology procedure code and a surgical procedure code to completely describe the service provided

30. Radiology Coding
To accurately code diagnostic radiology procedures, identify:
Anatomic site
Type of procedure
Number of views
Laterality of procedure
Use of contrast media

31. Vascular Procedures Selective vascular catheterization
Nonselective vascular catheterization

32. Coding Tip
Report a separate code when a diagnostic angiography or venography is performed during a separate session (from the interventional procedure).

33. Ultrasound Display Modes
A-mode (amplitude modulation)
B-scan (brightness mode, gray-scale ultrasound)
M-mode (motion mode)
Real-time scan

34. Ultrasound Guidance Procedures
Report either a diagnostic ultrasound or guidance ultrasound code, but not both for the same patient during the same encounter.

35. Radiation Oncology
Radiation oncology codes include professional services and technical procedures that are organized according to types of treatment provided:
Consultation
Clinical treatment planning
Radiation treatment delivery
Neutron beam treatment delivery

36. Clinical Treatment Planning
External sources
Internal sources
Systemic radiation therapy
Stereotactic radiosurgery (SRS)
Stereotactic body radiation therapy (SBRT)

37. Coding Tip Clinical treatment planning is reimbursed:
Once per course of radiation therapy
Only when performed directly by radiation oncologist

38. Therapeutic Radiology Treatment
Types of planning:
Simple
Intermediate
Complex

39. Radiation Treatment Delivery
Includes ongoing patient evaluation (codes not reported separately)
Codes are reported for administration of radiation therapy per treatment

40. Nuclear Medicine Subsection contains two headings: Therapeutic
Diagnostic