If a patient is having a computed tomography (CT) abdomen/pelvis without contrast (CPT® 74176) and the physician orders two doses of Omnipaque 3,000 mg (Q9967) in 500 ml of sterile water to be administered orally 30 minutes before the exam, can we bill separately for the contrast? If so, is the contrast billed per ml? (I understand that whether intravenous contrast was injected determines coding for CT. Only intravenous administration of contrast changes the code sets. Oral and/or rectal contrast is not billable as a “with contrast” study.)

Can we bill separately for the oral contrast if the test is ordered as a CT abdomen/pelvis with and without contrast (CPT 74178)? I would think we cannot bill separately for the oral contrast in this situation because the IV contrast would already be billed.

We have had many discussions on when it is appropriate to use 76706—ultrasound, abdominal aorta, real time with image documentation, screening study for abdominal aortic aneurysm (AAA). Can we still assign this code if the radiology report does not document screening for AAA for the history and only states patient with abdominal pain but the final impression states no evidence of AAA?