2025 CPT code 70486

Computed tomography (CT) scan of the maxillofacial area without contrast material.

Follow all applicable CPT coding guidelines and payer-specific instructions.Modifiers 26 and TC may be used to bill separately for professional and technical components. Payer-specific policies should be consulted regarding contrast coverage.

Modifiers 26 (professional component) and TC (technical component) are applicable.Modifier 59 (distinct procedural service) may be needed in certain circumstances, subject to payer guidelines.

Medical necessity for a CT scan of the maxillofacial area without contrast must be supported by clinical documentation, demonstrating that the exam is appropriate for the patient’s clinical presentation.The absence of contrast should be clinically justified (e.g., allergy, contraindication).

The radiologist or radiology technician is responsible for positioning the patient, operating the CT scanner, and acquiring the images. A physician (often a radiologist) interprets the images and generates a report.

IMPORTANT For similar studies with contrast, see CPT code 70487. For studies with and without contrast, see CPT code 70488.Modifiers 26 and TC may be appended depending on whether the professional or technical component is being billed separately.

In simple words: A CT scan of your face and jaw area is done without using any special dye to get clearer pictures.This helps doctors see bones and sinuses to diagnose problems like fractures or infections.

This CPT code describes a computed tomography (CT) scan of the maxillofacial region, encompassing the facial bones and sinuses.The procedure is performed without the administration of intravenous, intra-articular, or intrathecal contrast material.The CT scan generates cross-sectional images that aid in the diagnosis of various conditions affecting the maxillofacial area, including fractures, infections, tumors, and foreign bodies.

Example 1: A patient presents to the emergency department after a motor vehicle accident with facial trauma. A CT scan without contrast (70486) is performed to assess for fractures of the facial bones., A patient presents with chronic sinus pain and pressure. A CT scan without contrast (70486) is ordered to rule out sinusitis or other structural abnormalities., A patient with a history of maxillofacial surgery undergoes a follow-up CT scan without contrast (70486) to evaluate the healing process and identify any potential complications.

* Patient demographics and medical record number.* Reason for the exam (e.g., clinical indication, symptoms).* Imaging report including findings, interpretations, and clinical correlations.* If applicable, documentation justifying medical necessity.

** When 3D rendering is included, additional coding may be necessary (e.g., 76376 or 76377).Always refer to the most current CPT codebook and payer guidelines for accurate coding and billing.

  • Revenue Code: I2A (Advanced Imaging - CAT: Head)
  • RVU: This information varies by payer and geographic location. Consult the Medicare Physician Fee Schedule (MPFS) or other relevant payer fee schedules for current RVU values and reimbursement rates.
  • Global Days : The global period is not explicitly defined for this code.Consult payer specific guidelines.
  • Payment Status: Active
  • Modifier TC rule: Modifier TC applies when only the technical component (image acquisition) is billed separately.
  • Fee Schedule : Fee schedules vary by payer and geographic location.Historical fee schedule data can be obtained from payer websites or third-party billing resources.Information is not available in the provided text.
  • Specialties:Radiology, Oral and Maxillofacial Surgery, Emergency Medicine
  • Place of Service:Office, Hospital (Inpatient and Outpatient), Ambulatory Surgical Center, Emergency Room
** Only Enterprise users with EHR integration can access case-specific answers. Click here to request access.