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Official Description

Computed tomographic (CT) colonography, diagnostic, including image postprocessing; without contrast material

© Copyright 2025 American Medical Association. All rights reserved.

Common Language Description

Computed tomographic (CT) colonography, commonly known as virtual colonoscopy, is a non-invasive diagnostic imaging procedure used to visualize the colon and rectum. This procedure is particularly indicated for patients who exhibit signs or symptoms suggestive of bowel disease, such as abdominal pain, changes in bowel habits, or unexplained weight loss. Prior to the CT colonography, patients undergo a bowel preparation process the night before to ensure that the bowel is clear of stool, which is crucial for obtaining high-quality images. During the procedure, a small flexible tube is inserted into the rectum to introduce air or carbon dioxide gas into the colon, allowing for adequate distension of the bowel. This distension is essential for capturing clear images of the colon walls. The patient is positioned on the CT table, first in a supine position for the initial imaging pass, followed by a prone position for a second pass. The resulting non-contrast CT images of the abdomen and pelvis are then analyzed, and 3D reconstructions of the colon are created to enhance visualization. The physician interprets these images and generates a comprehensive written report detailing the findings, which may be compared to any prior radiological studies for a thorough assessment.

© Copyright 2025 Coding Ahead. All rights reserved.

1. Indications

CT colonography is performed for various indications related to bowel health. The following conditions or symptoms may warrant this diagnostic procedure:

  • Signs of Bowel Disease Patients exhibiting symptoms such as abdominal pain, changes in bowel habits, or unexplained weight loss may require evaluation through CT colonography.
  • Screening for Colorectal Cancer Individuals at average risk for colorectal cancer may undergo CT colonography as a screening tool, especially if they are unable or unwilling to undergo traditional colonoscopy.
  • Evaluation of Polyps Patients with a history of colorectal polyps may need CT colonography to monitor for new or recurrent polyps.
  • Assessment of Inflammatory Bowel Disease Patients diagnosed with conditions such as Crohn's disease or ulcerative colitis may require CT colonography to assess the extent of disease and any complications.

2. Procedure

The procedure for CT colonography involves several key steps to ensure accurate imaging of the colon. The following outlines the detailed procedural steps:

  • Bowel Preparation Prior to the procedure, patients must undergo bowel preparation, which typically includes dietary restrictions and the use of laxatives to clear the bowel of stool. This preparation is crucial for obtaining clear images during the CT colonography.
  • Patient Positioning On the day of the procedure, the patient is positioned on the CT table. The initial positioning is supine, where the patient lies on their back, allowing for the first pass of imaging.
  • Insertion of the Tube A small flexible tube is gently inserted through the anus and advanced approximately 2 inches into the rectum. This tube is used to introduce air or carbon dioxide gas into the colon, which is essential for distending the bowel for imaging.
  • Distension of the Colon Air or carbon dioxide gas is then pumped into the colon using a manual or electronic pump. This distension is necessary to ensure that the colon walls are adequately visualized during imaging.
  • First Imaging Pass Once the colon is adequately distended, the CT scanner is activated to obtain non-contrast images of the abdomen and pelvis while the patient remains in the supine position. This initial pass captures critical images of the colon.
  • Second Imaging Pass After the first set of images is obtained, the patient is repositioned to a prone position, lying on their stomach. A second pass through the CT scanner is then performed to capture additional images of the colon from this angle.
  • Image Processing and Review The non-contrast CT images are processed, and 3D reconstructions of the colon are created. Adjustments are made as necessary to optimize visualization. The physician then reviews the images, comparing them to any previously obtained radiological studies.
  • Interpretation and Reporting Finally, the physician interprets the CT images and compiles a written report detailing the findings, which may include the presence of polyps, tumors, or other abnormalities.

3. Post-Procedure

After the completion of the CT colonography, patients may experience mild discomfort or bloating due to the air or gas introduced into the colon. It is generally recommended that patients resume normal activities shortly after the procedure, as it is non-invasive. However, they should be advised to monitor for any unusual symptoms, such as severe abdominal pain or rectal bleeding, and to contact their healthcare provider if such symptoms occur. The physician will provide the patient with the written report of findings, which may be discussed in a follow-up appointment to determine any necessary next steps or further evaluations based on the results.

Short Descr CT COLONOGRAPHY DX
Medium Descr CT COLONOGRPHY DX IMAGE POSTPROCESS W/O CONTRAST
Long Descr Computed tomographic (CT) colonography, diagnostic, including image postprocessing; without contrast material
Status Code Active Code
Global Days XXX - Global Concept Does Not Apply
PC/TC Indicator (26, TC) 1 - Diagnostic Tests for Radiology Services
Multiple Procedures (51) 4 - Special payment adjustment rules on the technical component (TC) of multiple diagnostic imaging procedures apply...
Bilateral Surgery (50) 0 - 150% payment adjustment for bilateral procedures does NOT apply.
Physician Supervisions 09 - Concept does not apply.
Assistant Surgeon (80, 82) 0 - Payment restriction for assistants at surgery applies to this procedure...
Co-Surgeons (62) 0 - Co-surgeons not permitted for this procedure.
Team Surgery (66) 0 - Team surgeons not permitted for this procedure.
Diagnostic Imaging Family 88 -
APC Status Indicator Codes That May Be Paid Through a Composite APC
ASC Payment Indicator Radiology service paid separately when provided integral to a surgical procedure on ASC list; payment based on OPPS relative payment weight.
Type of Service (TOS) 4 - Diagnostic Radiology
Berenson-Eggers TOS (BETOS) I2B - Advanced imaging - CAT/CT/CTA: other
MUE 1
CCS Clinical Classification 179 - CT scan abdomen

This is a primary code that can be used with these additional add-on codes.

0722T Add On Code MPFS Status: Carrier Priced APC S Quantitative computed tomography (CT) tissue characterization, including interpretation and report, obtained with concurrent CT examination of any structure contained in the concurrently acquired diagnostic imaging dataset (List separately in addition to code for primary procedure)
26 Professional component: certain procedures are a combination of a physician or other qualified health care professional component and a technical component. when the physician or other qualified health care professional component is reported separately, the service may be identified by adding modifier 26 to the usual procedure number.
X5 Diagnostic services requested by another clinician: for reporting services by a clinician who furnishes care to the patient only as requested by another clinician or subsequent and related services requested by another clinician; this modifier is reported for patient relationships that may not be adequately captured by the above alternative categories; reporting clinician service examples include but are not limited to, the radiologist's interpretation of an imaging study requested by another clinician
TC Technical component; under certain circumstances, a charge may be made for the technical component alone; under those circumstances the technical component charge is identified by adding modifier 'tc' to the usual procedure number; technical component charges are institutional charges and not billed separately by physicians; however, portable x-ray suppliers only bill for technical component and should utilize modifier tc; the charge data from portable x-ray suppliers will then be used to build customary and prevailing profiles
MH Unknown if ordering professional consulted a clinical decision support mechanism for this service, related information was not provided to the furnishing professional or provider
GA Waiver of liability statement issued as required by payer policy, individual case
GC This service has been performed in part by a resident under the direction of a teaching physician
MG The order for this service does not have applicable appropriate use criteria in the qualified clinical decision support mechanism consulted by the ordering professional
GZ Item or service expected to be denied as not reasonable and necessary
CT Computed tomography services furnished using equipment that does not meet each of the attributes of the national electrical manufacturers association (nema) xr-29-2013 standard
CR Catastrophe/disaster related
52 Reduced services: under certain circumstances a service or procedure is partially reduced or eliminated at the discretion of the physician or other qualified health care professional. under these circumstances the service provided can be identified by its usual procedure number and the addition of modifier 52, signifying that the service is reduced. this provides a means of reporting reduced services without disturbing the identification of the basic service. note: for hospital outpatient reporting of a previously scheduled procedure/service that is partially reduced or cancelled as a result of extenuating circumstances or those that threaten the well-being of the patient prior to or after administration of anesthesia, see modifiers 73 and 74 (see modifiers approved for asc hospital outpatient use).
53 Discontinued procedure: under certain circumstances, the physician or other qualified health care professional may elect to terminate a surgical or diagnostic procedure. due to extenuating circumstances or those that threaten the well being of the patient, it may be necessary to indicate that a surgical or diagnostic procedure was started but discontinued. this circumstance may be reported by adding modifier 53 to the code reported by the individual for the discontinued procedure. note: this modifier is not used to report the elective cancellation of a procedure prior to the patient's anesthesia induction and/or surgical preparation in the operating suite. for outpatient hospital/ambulatory surgery center (asc) reporting of a previously scheduled procedure/service that is partially reduced or cancelled as a result of extenuating circumstances or those that threaten the well being of the patient prior to or after administration of anesthesia, see modifiers 73 and 74 (see modifiers approved for asc hospital outpatient use).
59 Distinct procedural service: under certain circumstances, it may be necessary to indicate that a procedure or service was distinct or independent from other non-e/m services performed on the same day. modifier 59 is used to identify procedures/services, other than e/m services, that are not normally reported together, but are appropriate under the circumstances. documentation must support a different session, different procedure or surgery, different site or organ system, separate incision/excision, separate lesion, or separate injury (or area of injury in extensive injuries) not ordinarily encountered or performed on the same day by the same individual. however, when another already established modifier is appropriate it should be used rather than modifier 59. only if no more descriptive modifier is available, and the use of modifier 59 best explains the circumstances, should modifier 59 be used. note: modifier 59 should not be appended to an e/m service. to report a separate and distinct e/m service with a non-e/m service performed on the same date, see modifier 25.
76 Repeat procedure or service by same physician or other qualified health care professional: it may be necessary to indicate that a procedure or service was repeated by the same physician or other qualified health care professional subsequent to the original procedure or service. this circumstance may be reported by adding modifier 76 to the repeated procedure or service. note: this modifier should not be appended to an e/m service.
CC Procedure code change (use 'cc' when the procedure code submitted was changed either for administrative reasons or because an incorrect code was filed)
FY X-ray taken using computed radiography technology/cassette-based imaging
GV Attending physician not employed or paid under arrangement by the patient's hospice provider
GW Service not related to the hospice patient's terminal condition
GX Notice of liability issued, voluntary under payer policy
GY Item or service statutorily excluded, does not meet the definition of any medicare benefit or, for non-medicare insurers, is not a contract benefit
MA Ordering professional is not required to consult a clinical decision support mechanism due to service being rendered to a patient with a suspected or confirmed emergency medical condition
MB Ordering professional is not required to consult a clinical decision support mechanism due to the significant hardship exception of insufficient internet access
MC Ordering professional is not required to consult a clinical decision support mechanism due to the significant hardship exception of electronic health record or clinical decision support mechanism vendor issues
ME The order for this service adheres to appropriate use criteria in the clinical decision support mechanism consulted by the ordering professional
MF The order for this service does not adhere to the appropriate use criteria in the clinical decision support mechanism consulted by the ordering professional
Q6 Service furnished under a fee-for-time compensation arrangement by a substitute physician or by a substitute physical therapist furnishing outpatient physical therapy services in a health professional shortage area, a medically underserved area, or a rural area
QQ Ordering professional consulted a qualified clinical decision support mechanism for this service and the related data was provided to the furnishing professional
XP Separate practitioner, a service that is distinct because it was performed by a different practitioner
XU Unusual non-overlapping service, the use of a service that is distinct because it does not overlap usual components of the main service
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2011-01-01 Changed Short description changed.
2010-01-01 Added -
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