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2025 CPT code 76380

Computed tomography, limited or localized follow-up study; a targeted CT scan focusing on a specific area previously imaged to monitor changes or treatment effectiveness.

Adhere to CPT guidelines for radiology coding.Modifiers 26 and TC may be necessary depending on the components billed.Documentation should clearly justify the medical necessity for this limited study.

Modifiers 26 (professional component), 52 (reduced services), 59 (distinct procedural service), and TC (technical component) may be applicable depending on the circumstances of service.

Medical necessity for a follow-up CT scan (76380) is established when there's a clinical need to monitor a previously identified condition, assess treatment effectiveness, or investigate suspected complications.Documentation supporting medical necessity should correlate the findings to the clinical picture.

The clinical responsibility involves the radiologist ordering the CT scan, the radiology technician performing the scan, and the radiologist interpreting the images and providing a report to the referring physician.

IMPORTANT:This code is mutually exclusive with other CT codes for the same session.Specific codes (e.g., those for arthrography of specific joints) should be used instead of 76380 for those procedures.If only physician interpretation is reported, use modifier 26. If only the technical component is reported, use modifier TC (though payer policies may vary for hospitals).

In simple words: This code describes a special type of CT scan used to check on a specific area that's already been scanned before.The doctor uses this focused scan to see if a problem is getting better, worse, or staying the same after treatment or to look for changes. It's like taking another, closer look at just the important part.

CPT code 76380 represents a computed tomography (CT) scan limited to a specific area, used as a follow-up study.It's indicated when a prior CT scan has already been performed, and a more targeted assessment of a previously identified region is necessary. This might involve monitoring a known condition, evaluating treatment response, or investigating suspected complications or tumor progression. The procedure involves using a CT scanner to acquire multiple X-ray images of the targeted area, which are then processed by a computer to generate detailed cross-sectional images.This focused approach contrasts with more comprehensive CT scans which cover broader areas.The code 76380 should not be billed with other CT, CT angiography, or CT guidance codes performed during the same session. Modifiers may be appended to this code to indicate reduced services (modifier 52) or distinct procedural service (modifier 59) based on the clinical circumstances.

Example 1: A patient with a known lung nodule undergoes a follow-up CT scan (76380) six months after initial diagnosis to assess nodule size change and response to treatment., A patient post-abdominal surgery experiences persistent pain. A targeted CT scan (76380) of the surgical site is ordered to rule out complications such as infection or hematoma., A patient with a history of colon cancer has a follow-up CT scan (76380) of the abdomen and pelvis to monitor for recurrence after chemotherapy.

* Reason for the follow-up CT scan.* Comparison with previous imaging studies.* Detailed description of the area scanned.* Radiologist's interpretation and report.* Relevant clinical information (e.g., patient history, treatment details).

** This code is typically used for targeted follow-up studies, not for initial imaging.Always ensure that the clinical documentation supports the medical necessity for the procedure.Payer specific policies and guidelines may need to be considered for accurate billing.

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