RADIOLOGY AND DIAGNOSTIC IMAGING
Radiology lives in the 70000s
The entire radiology section runs from 70010–79999 and is organized first by body area, then by modality (X-ray, CT, MRI, ultrasound, etc.) within each area.
Body Area Ranges to Know
Range | Body Area |
|---|---|
70010–70559 | Head & Neck |
70553–70559 | Brain |
71045–71555 | Chest |
72010–72295 | Spine & Pelvis |
73000–73725 | Upper & Lower Extremities |
74000–74340 | Abdomen |
74710–74775 | Pelvis (GYN) |
76000–76999 | Ultrasound |
77000–77799 | Radiation Oncology |
78000–78999 | Nuclear Medicine |
Within Each Body Area — Modality Order
Once you're in the right body area, codes are generally arranged in this order:
Plain X-ray (fewest digits of complexity, lowest codes)
CT scan
MRI
Angiography/special procedures
Contrast Logic — Applies to CT and MRI
Every CT and MRI code comes in three flavors:
Suffix pattern | Meaning |
|---|---|
Without contrast | No contrast used at all |
With contrast | Contrast only |
Without followed by with | Both — contrast added after initial scan |
On the exam, the operative/radiology report will always tell you whether contrast was used. Never assume!
The Combination Code Rule — High Yield!
When two adjacent body areas are scanned in the same session, CPT often has a single combination code that must be used instead of billing separately. The most tested ones:
Study | W/O contrast | W/ contrast | W/ & W/O |
|---|---|---|---|
CT Abd + Pelvis | 74176 | 74177 | 74178 |
MRI Abd + Pelvis | 74182 | 74183 | 74184 |
Billing them separately = unbundling = automatic denial. This is one of the most tested traps on the CPC!
Modifier -26 vs TC vs Global
Situation | Modifier |
|---|---|
Physician interprets only, facility owns equipment | -26 (professional component) |
Facility bills for equipment/tech only | -TC (technical component) |
Physician owns equipment AND interprets | No modifier (global billing) |
Quick Index Navigation Tip (For the ebook your process would look something like:
Ctrl+F the modality (e.g. "CT" or "MRI") then scan for your body part nearby
Ctrl+F the body part (e.g. "knee" or "abdomen") and filter by whether you're in the tabular or index section)
Once you find the code range, scan up and down for the contrast variation you need
In your CPT index, look up:
CT scan → then the body part
or
MRI → then the body part
This will point you directly to the right code range much faster than searching by body part first.
| Who does what | Modifier | |---|---|| Radiologist interprets only, hospital owns equipment | -26 | | Hospital bills for equipment/tech only | -TC | | Radiologist owns equipment + interprets | No modifier (global) | (For No modifier, TC, or 26)
Radiology Modifier Cheat Sheet
Scenario | Who Bills | Modifier | Example |
|---|---|---|---|
Radiologist interprets only, hospital/facility owns equipment | Radiologist | -26 | Hospital outpatient imaging center, radiologist reads the scan |
Hospital/facility owns equipment, radiologist interprets separately | Hospital/Facility | -TC | Hospital bills for the machine and tech, separate from the radiologist |
Radiologist owns equipment AND interprets in their own clinic/practice | Radiologist | None (Global) | Independent radiology clinic, same doc owns and reads |
Physician orders AND interprets their own in-office imaging | Physician | None (Global) | Pulmonologist interprets their own in-office chest X-ray |
"Is the global service being split between two separate parties?"
✅ Yes → Split it: Facility bills -TC, Radiologist bills -26
❌ No → Same person does it all → No modifier, global billing
Memory Hook:
-26 = "26 letters in the alphabet, A to Z, the radiologist reads A to Z of the report" → interpretation
-TC = "TC = The Clinic/facility owns the equipment" → technical/equipment
No modifier = "One person, whole pie, no split" → global
If documentation says there are symptoms but uses “screening” you must use diagnostic- otherwise if it is asymptomatic, screening codes are fine.