2025 CPT code 76380
(Active) Effective Date: N/A Revision Date: N/A Diagnostic Radiology - Other Diagnostic Radiology (Diagnostic Imaging) Related Procedures Radiology Feed
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.
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.
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.
- Revenue Code: I2B (ADVANCED IMAGING - CAT: OTHER)
- RVU: Relative Value Units (RVUs) vary based on geographic location, payer, and other factors. Consult appropriate fee schedules for current values.
- Global Days: This code does not have a defined global period. Each follow-up CT scan is billed separately.
- Payment Status: Active
- Modifier TC rule: Modifier TC (technical component) may be used if only the technical aspects of the procedure are billed.However, payer policies may exempt hospitals from appending this modifier.
- Fee Schedule: Historical fee schedule data is not readily available in the provided source.Consult appropriate fee schedules for historical and current reimbursement data.
- Specialties:Radiology, Oncology, Surgery (depending on context)
- Place of Service:Inpatient Hospital, Outpatient Hospital, Ambulatory Surgical Center, Office