CPT Code 74160: CT Abdomen With Contrast Billing Guide for 2026

CPT code 74160 reports a CT scan of the abdomen with contrast when the session includes no pelvic imaging. For coding, contrast means intravascular contrast, the IV injection on an abdomen CT. Oral or rectal contrast alone doesn’t qualify, so those studies stay at 74150.

Add the pelvis with contrast and you’ll bill 74177. If the radiologist also reads a diagnostic noncontrast series first, 74170 is the right code. Medicare lists 74160 as active for 2026, with a $230.13 national allowed amount for the global service before your locality adjustment.

Picking the right CT abdomen with contrast CPT code comes down to two facts on the signed report. One is the anatomy the radiologist read. The other is which contrast phases the technologist acquired.

CPT 74160 at a Glance: 2026 Quick Facts

These are the 2026 reference values for CPT code 74160, pulled from the October 2026 Centers for Medicare & Medicaid Services (CMS) fee schedule and edit files. Hospital and surgery center rates come from the July 2026 addenda, so your coders won’t need three CMS files open.

CT of abdomen with contrast CPT code: 2026 reference values

Sources: CMS fee schedule RVU files (RVU26D, October 2026 release), National Correct Coding Initiative (NCCI) MUE tables effective October 1, 2026, the OPPS and ASC July 2026 addenda, and CPT 2026. CMS updates these values each January and again each quarter.

What CPT Code 74160 Covers and What It Doesn’t

74160 is the CPT code for abdominal CT with contrast when three facts hold on the signed report. Miss one of them and the claim belongs under a different code, so check the report against the order before you bill.

• The study covered the abdomen only, and the radiologist read it.
• Contrast went in through a vein, with or without oral contrast.
• No diagnostic noncontrast series came before the contrast pass.

The Official 74160 CPT Code Description

CPT code 74160 carries the descriptor “Computed tomography, abdomen; with contrast material(s),” and it sits in the Diagnostic Radiology section of CPT. CMS shortens it to “Ct abdomen w/contrast” in the fee schedule files and to “Ct abdomen w/dye” on its CT modifier reduction list.

Read the descriptor in two halves. The text before the semicolon, “Computed tomography, abdomen,” is common to 74150, 74160, and 74170. Only the words after it change, so your coders can sort the whole family by reading past that semicolon.

Where the Abdomen Ends for Coding Purposes

For 74160, the abdomen runs from the dome of the diaphragm to the iliac crests, covering the liver, gallbladder, pancreas, spleen, kidneys, adrenal glands, and upper bowel. Your coders should work from the signed report, since that’s the document a reviewer compares against the claim and the order.

Slices through the lung bases or the top of the pelvis don’t change the code. An incidental comment on the bladder dome doesn’t change it either. A combined code needs a pelvis that the treating physician ordered and the radiologist scanned and read in full.

In the common case, the order reads “CT abdomen.” The radiologist protocols a full abdomen and pelvis study, and the report covers both regions. Medicare needs an amended order from the treating physician before you bill 74177, plus an updated authorization. Without that order, the pelvis portion isn’t billable.

What “With Contrast” Means on a CT Abdomen Claim

For 74160, “with contrast” means intravascular, intra-articular, or intrathecal contrast, and on an abdomen CT that’s the IV injection. Oral or rectal contrast on its own doesn’t qualify under CPT’s radiology guidelines. Some published billing guides still count oral contrast toward 74160, so check any guide against the CPT definition.

• Oral contrast only: 74150
• Oral plus IV contrast: 74160, because the IV contrast qualifies
• IV contrast ordered but withheld, such as for a low estimated glomerular filtration rate (eGFR): 74150
• Scout or topogram before the contrast pass: still 74160, since a scout isn’t a noncontrast series

Have your coders read the technique section before the impression, since they pick between 74150 and 74160 from the contrast route listed there. A clean technique section names the agent, the route, and the volume given.

Coding rule: oral or rectal contrast alone codes as without contrast (74150).

Clinical Indications That Fit a CT of the Abdomen Alone

Payers approve 74160 with the least friction when the suspected disease sits inside the abdomen. Radiologists image the pelvis too for nonlocalized pain and most trauma workups, and radiology benefit managers steer those orders toward the combined codes.

• Liver lesion follow-up after an indeterminate ultrasound
• Suspected liver or upper abdominal abscess
• Pancreatitis complications or a suspected pancreatic mass
• Renal, adrenal, or splenic findings confined to the abdomen
• Oncology surveillance for liver or pancreatic primaries

Two Questions That Pick the Right CT Abdomen Code

Your coders can confirm 74160, the CPT code for CT abdomen with contrast, or move to a sibling code by answering two questions from the signed report. Answer both before charge entry, and check that the order covers the study the report describes.

Question 1: Was the Pelvis Imaged in the Same Session?

If the radiologist read the pelvis in the same session, you’re in the combined family, 74176 to 74178, and 74160 drops out. CPT won’t let you report the combined codes with 74150, 74160, or 74170 for one session. Our guide to CT abdomen and pelvis codes maps each combined option.

Question 2: Which Contrast Phases Does the Report Document?

A report that documents only contrast-enhanced images supports 74160. Add a diagnostic noncontrast series read before the contrast pass and the code becomes 74170, while a study with no contrast at all is 74150. Multiple contrast phases, such as arterial plus portal venous, still count as one 74160.

CT abdomen code selection by pelvis and contrast status (find the abdomen row, then the pelvis column)

If your charge entry staff codes from the order alone, they’ll land in the wrong cell of this matrix. Our medical billing service team adds a signed report check to charge review. The code then matches the read and the order.

CPT 74160 vs 74150, 74170, 74175, 74177, and 74182

Coders confuse 74160 with five neighboring codes, and each error turns on a single fact: anatomy, contrast phase, arterial timing, or modality. Your coders pick the right code by spotting that one fact on the signed report.

CPT Code 74160 vs 74177: Abdomen Only or Abdomen and Pelvis

74160 covers the abdomen alone, while 74177 covers the abdomen and pelvis with contrast, so you can’t bill both for one CT session. NCCI lists 74177 in Column 1 and 74160 in Column 2, and Medicare pays the combined code while denying the abdomen line.

The edit carries modifier indicator 1, so XE works for two documented encounters on one date. Each study needs its own order, its own signed report, and a clinical reason for the second trip to the scanner.

Both codes on one scan is a coding error. Send a corrected claim to commercial payers or request a reopening from Medicare Part B instead of appealing. Our abdomen and pelvis CT guide shows the combined code for each contrast pairing.

74160 vs 74150 and 74170: The Three CT Abdomen CPT Codes

74150, 74160, and 74170 are the three codes for CT of the abdomen alone, split by contrast: none, contrast only, or a noncontrast series followed by contrast. The CT abdomen without contrast CPT code is 74150, and a study read without contrast, then with contrast, is 74170.

CPT code for CT abdomen by contrast status (2026)

At 2026 national rates, CPT code 74150 pays $136.28 and CPT code 74170 pays $258.86, compared with $230.13 for 74160. The 74170 CPT code description reads “without contrast material, followed by contrast material(s) and further sections.” Your coders need a diagnostic noncontrast series to support it.

Bolus tracking slices taken to time the injection don’t count as the noncontrast half. Pick the abdominal CT CPT code from the series list in the report, since protocol names vary from one facility to the next.

74160 vs 74175: Contrast CT or CT Angiography

CPT code 74175 is CT angiography (CTA) of the abdomen, and it differs from 74160 in timing and image postprocessing. A CTA uses a timed arterial bolus, and 74175 already includes any noncontrast images.

74175, the CTA abdomen CPT code, needs an order and a technique section that describe an angiographic study with 3D postprocessing. A routine 74160 report that mentions the vessels or includes multiplanar reformats stays at 74160.

74160 vs 74182: CT or MRI of the Abdomen With Contrast

74182 is MRI of the abdomen with contrast, so it shares a region and a contrast status with 74160 on a different modality. Charge masters sorted by body region can place the 74182 CPT code beside the CT abdomen codes.

Check the modality first if 74182, the MRI of abdomen with contrast CPT code, shows up on a CT claim. Read the order and the report header before anything else. Our list of MRI CPT codes by region covers 74181 to 74183 and the other MRI families.

Can You Bill 74160 With 72193?

No, not for one session: 74160 plus 72193 describes an abdomen and pelvis CT with contrast, and CPT requires 74177 for that combination. Billing CPT code 72193 alongside 74160 unbundles the study, and Medicare denies the pelvis line under the NCCI edit that pairs the two codes.

The pair carries modifier indicator 1 in the CMS NCCI procedure-to-procedure edits. That lets a modifier bypass the edit for separate encounters, such as a morning abdomen CT and an evening pelvis CT after a fall. One scan split into two lines doesn’t qualify.

Documentation That Holds Up on a 74160 Claim

On a 74160 claim, payers check the order, the contrast record, the anatomy scanned, and the signed read. A claim for a CT scan of the abdomen with contrast can meet clean claim requirements at submission. Months later, it can still fail a records request over one missing piece.

What the Order and the Report Must Show

A defensible 74160 chart holds the items below, and a Medicare reviewer should find each one without calling your office. Build this list into the check your coders run on imaging claims before they drop.

• An order, or a chart note showing the treating physician’s intent, naming the body area and indication
• An indication that matches the ICD-10-CM code on the claim
• A technique section naming the IV agent, route, and volume, with oral contrast listed on its own
• A statement of the anatomy scanned, with findings limited to the abdomen
• A precontrast series labeled as diagnostic, if the claim is going out as 74170
• A signed, dated interpretation before any modifier 26 claim drops

When the Order and the Report Disagree

For 74160 and its siblings, you code what the signed report documents, and Medicare also needs a treating physician’s order covering that study. Contrast is the exception. Medicare treats contrast use as test design under Benefit Policy Manual Chapter 15, so the radiologist can change it without a new order.

• Contrast ordered but withheld: bill 74150 and ask whether the plan needs an updated authorization
• “CT abdomen” ordered, pelvis read with contrast: get an amended order, update the authorization, and bill 74177
• “CT abdomen and pelvis” ordered, abdomen scanned alone with contrast: bill 74160 and update the authorization if the plan requires it

Noridian’s 74177 review findings for October through December 2025 list three top denial reasons. Requested records didn’t arrive, documentation was incomplete, or the records didn’t support medical necessity. A fast records response handles the first. Your team can close the other two gaps before billing.

Medicare Coverage and Medical Necessity for CPT Code 74160

NCD 220.1 Sets the National Rule

Medicare’s national rule for 74160 is NCD 220.1 for computed tomography, which covers CT when the scan is reasonable and necessary for the individual patient. The NCD sets no general rule that other tests come first, so an ultrasound isn’t a prerequisite on paper.

Your MAC can still find that CT as a first test wasn’t reasonable if the symptoms on the claim don’t support it. Reviewers also watch for missing indications, too many scans, and scan types pricier than the clinical question needed.

LCDs and Billing Articles Add Regional Detail

For 74160, your MAC may publish an LCD and a billing article that list covered diagnosis codes. Some MACs publish neither for CT abdomen. Check your own contractor’s articles before you rely on anyone else’s list.

Palmetto GBA’s LCD L34415 and Palmetto’s billing article A56421 apply only in Alabama, Georgia, Tennessee, South Carolina, Virginia, West Virginia, and North Carolina. A56421 isn’t national Medicare policy. Group 1 of that article lists more than 5,000 ICD-10-CM codes that support medical necessity.

Revision 21, effective October 1, 2026, adds K6A.01 (prevesical abscess), K6A.09 (other pelvic abscess), and K6A.8 (other diseases of the pelvis, not elsewhere classified). Those are pelvic diagnoses, and on their own they support a pelvis or combined study better than 74160.

Revision 20, effective November 1, 2025, added flank pain codes R10.A1, R10.A2, and R10.A3 retroactive to October 1, 2025. Reopen flank pain denials for October 2025 dates of service in Palmetto’s states. Those claims now have covered codes.

Commercial Payers, RBMs, and Prior Authorization

Original Medicare doesn’t require prior authorization for an outpatient 74160, but most Medicare Advantage and commercial plans do, through a radiology benefit manager (RBM). The RBM names your staff will see most are Carelon, eviCore, and Evolent.

RBM guidelines set a high bar for a CT of the abdomen alone. Evolent’s Louisiana Healthcare Connections CT guideline approves abdomen CT alone only when the suspected disease is limited to the abdomen. If an office sends separate abdomen and pelvis requests, the RBM returns them for resubmission as one combined study.

The authorized CPT has to match the code you bill. If the radiologist extends the protocol from 74160 to 74177, get an amended order and an updated authorization before the claim goes out. Your eligibility and authorization workflow should flag imaging orders before the patient reaches the scanner.

If your team keeps seeing CO-15 or CO-197 denials, the authorization step needs work. Our insurance eligibility verification services team checks the requirement at scheduling and matches the approved CPT to the signed report before billing.

The AUC Program Is Gone, So Drop Those Modifiers

No Appropriate Use Criteria (AUC) modifiers or G codes belong on a 74160 claim, because CMS rescinded the program’s regulations effective January 1, 2024. Scrub Healthcare Common Procedure Coding System (HCPCS) codes G1000 to G1024 and modifiers MA to MH and QQ from your claims.

Old charge templates and electronic health record (EHR) order sets still append them, so audit both and delete the defaults at the source. Our CPT 71250 AUC status guide covers the same cleanup for chest CT, including the modifier list.

ICD-10-CM Codes That Support CPT Code 74160

Any ICD-10-CM code on a 74160 claim has to explain why the abdomen alone needed imaging with contrast. Code to the highest specificity the record supports, and match the diagnosis to the reason on the order.

R93.5 is the ICD-10 code for an abnormal CT of the abdomen when no more specific R93 code fits. That covers the retroperitoneum and other unlisted regions. Use R93.2 for liver and biliary findings, R93.3 for the stomach and bowel, and R93.421 to R93.429 for the kidneys.

Swap R93.5 for the confirmed diagnosis once a physician documents one. Symptom and finding codes carry less weight on review than a named condition.

R10.9, unspecified abdominal pain, gives weak support for a study limited to the abdomen, because it doesn’t say where the pain is. Several RBMs want the quadrant, so pick R10.11 or R10.13 if the note documents location.

New FY 2027 ICD-10-CM codes apply to encounters from October 1, 2026, through September 30, 2027, so update your code pickers if you haven’t. The CMS FY 2027 ICD-10-CM files list the additions, and your MAC article or payer policy shows which ones support 74160.

Modifiers for CPT 74160: 26, TC, CT, and the X Modifiers

CPT code 74160 needs no modifier when one entity owns the scanner and reads the study. Modifiers come in for three reasons. Billing splits between two entities, the scanner falls short of a federal CT dose standard, or the patient returns for a second session.

Global, 26, and TC: Who Bills Which Component

For 74160, the entity that owns the scanner bills the technical component and the reading radiologist bills the professional component. One entity can also bill both as a global claim. The place of service (POS) tells you which one applies.

The costly error is a radiologist billing global 74160 for a hospital scan, with no modifier 26. By then the hospital has billed its side on the UB-04, so the payer denies the radiologist’s claim. Our guide to POS 22 billing rules covers the on-campus split in detail.

The TC carries physician supervision indicator 02, so an office or independent diagnostic testing facility (IDTF) needs direct physician supervision for 74160. Since January 1, 2026, CMS accepts real-time audio and video presence for that supervision, while the noncontrast 74150 needs only general supervision.

Modifier CT: 15% Off the Technical Component

Medicare cuts the 74160 technical component by 15% if your scanner fails National Electrical Manufacturers Association (NEMA) standard XR-29-2013, and modifier CT reports it. The reduction comes from Section 218(a) of the Protecting Access to Medicare Act and hits the TC, including the TC share of a global claim.

74160 sits on the CMS CT modifier reduction list for 2026, and the remittance shows CO-237 with remark code N759. Hospitals see the same 15% cut under OPPS. Post it as a legislated reduction, confirm the scanner’s XR-29 status, and skip the appeal.

74160 With XU or XE: Which One Fits?

If the patient gets 74160 and a bundled study such as 72193 at separate encounters on the same date, XE is the modifier. XU seldom fits a diagnostic CT, since a second scan of a new region isn’t an unusual non-overlapping service.

CMS defines XE as a separate encounter, XS as a separate structure, XP as a separate practitioner, and XU as an unusual non-overlapping service. Use modifier 59 only when none of the four fits, per CMS guidance on X modifiers.

A different diagnosis alone doesn’t justify an X modifier, and no modifier overrides an edit with modifier indicator 0. Our guide to modifier 59 and X modifiers walks through the CMS examples line by line.

76, 77, 52, and 53: Repeat, Reduced, and Stopped Studies

Report a same-day repeat 74160 with 76 when the same physician repeats it and 77 when a different physician does. Because the MUE is one unit with a date of service edit, expect the second unit to deny and to need records on appeal.

Modifier 52 marks a reduced study, and 53 marks one the physician stopped for patient safety. Under OPPS, hospitals report a discontinued CT with 52. Leave 91 and 22 off 74160: 91 is for repeat lab tests, and 22 is hard to defend on a CT.

NCCI Edits and MUE Limits on CPT Code 74160

How Column 1, Column 2, and the Modifier Indicator Work

If 74160 and another code in an NCCI edit pair go out together, Medicare pays the Column 1 code and denies the Column 2 code. A modifier indicator of 0 means the pair can’t pay together, with or without a modifier.

An indicator of 1 lets a modifier bypass the edit, but only when the chart supports a separate site or a separate encounter. The Medicare NCCI Policy Manual adds a rule coders forget: you still owe correct coding when no edit fires.

Pairs to Check Before a 74160 Claim Goes Out

These are the 74160 edit pairs from the practitioner procedure-to-procedure (PTP) file effective October 1, 2026, that your coders will hit on CT abdomen claims. The indicator column tells you whether a modifier is even possible.

Source: CMS NCCI practitioner PTP edits, version 32.3, effective October 1, 2026.

MUE: One Unit of 74160 per Date of Service

The practitioner MUE for 74160 is one unit per date of service, with MUE adjudication indicator 3, a date of service edit based on clinical benchmarks. Medicare adds units across claim lines, so splitting a repeat onto a second line with 76 doesn’t avoid the edit.

Your MAC can pay a unit above an MAI 3 limit on redetermination. The records have to show the patient needed both scans, such as a second scan after a biopsy to rule out a bleed. Hospital outpatient claims face the same one-unit limit in the CMS MUE tables.

Q4 2026 Edit Files Take Effect October 1, 2026

The October 2026 NCCI files that govern 74160 take effect October 1, 2026, and CMS posted the PTP edits on September 2. A scrubber still running third-quarter files will pass claims that deny and hold claims that should pay. Match the edit quarter to the date of service.

CPT 74160 Reimbursement in 2026

The 74160 CPT code reimbursement for 2026 is a $230.13 national Medicare allowed amount for the global service. Your setting, the component you bill, your locality, and any same-session imaging then change what you collect.

2026 National Medicare Rate for CPT Code 74160

CPT code 74160 has a 2026 national allowed amount of $230.13: 1.24 work, 5.56 practice expense, and 0.09 malpractice RVUs total 6.89, times the $33.4009 conversion factor. Clinicians who earn qualifying participant (QP) status in an advanced alternative payment model (APM) get the $33.5675 factor, for a $231.28 national amount.

Facility and non-facility totals are both 6.89, so the site of service doesn’t change the global rate. Your MAC adjusts the amount with the GPCI for your locality. Medicare pays 80% after the Part B deductible, and 2% sequestration comes off Medicare’s share. The patient owes the other 20%.

Why Some Sources Show $227.07 and Others $230.13

74160 paid $227.07 in 2025 on 7.02 RVUs (1.27 work, 5.67 practice expense, 0.08 malpractice) at $32.3465, and that’s the older figure you’ll still see quoted. If a rate source lists 7.02 RVUs, it’s running 2025 data.

For 2026, CMS cut the work RVU to 1.24 with the 2.5% efficiency adjustment for non-time-based services in the 2026 fee schedule final rule. Practice expense fell to 5.56, the conversion factor rose, and the net change is $3.06 more per global claim.

Professional vs Technical Component Payment

In 2026, the 74160 professional component pays $58.45 and the technical component pays $171.68 at national rates, adding up to the $230.13 global amount. Modifiers 26 and TC don’t go on the same claim line.

Same-Session CT Chest and Abdomen: The MPPR Cut

If your practice bills 74160 and 71260 for one session, Medicare pays both and applies the multiple procedure payment reduction (MPPR) to the lower-priced study. The rule runs on multiple procedure indicator 4, and it splits the cut by component.

• The highest-priced technical and professional components pay in full
• The next study’s technical component pays at 50%
• The next study’s professional component pays at 95%, the rate in place since 2017

Medicare applies it for the same physician or group, patient, session, and day, per Noridian’s imaging MPPR guidance. No PTP edit links 74160 to a CT thorax with contrast study, so skip the modifier and let the reduction post.

Hospital Outpatient and ASC Payment

Hospitals bill the 74160 technical side under OPPS, where it carries status indicator Q3 and maps to APC 5571 at $179.20 in the July 2026 CMS OPPS quarterly addenda. The minimum unadjusted copayment on APC 5571 is $35.84.

Bill 74160 on the same date as another CT or CTA, and OPPS groups the studies into composite APC 8006. That composite pays $438.90 for the set. Check the October 2026 addenda once CMS posts them, since rates can shift by quarter.

In an ambulatory surgical center, 74160 pays only as an ancillary service integral to a covered surgical procedure. CMS lists it in ASC Addendum BB with payment indicator Z2 and a July 2026 national rate of $97.27.

Commercial Rates and What the Patient Pays

Commercial allowed amounts for 74160 vary by contract and setting, and hospitals publish negotiated rates in their price transparency files. Use Medicare’s $230.13 as the yardstick for office and professional contracts, and the OPPS $179.20 for hospital outpatient contracts.

The Medicare Procedure Price Lookup shows a 2026 national average patient cost of $70 in a hospital outpatient department and $65 in an ambulatory surgical center. Front desk staff can share those figures as a rough range, then check the patient’s own benefits before quoting a number.

If 74160 payments don’t match your contracts, check payment posting first. Our revenue cycle management services team flags underpayments by CPT code and payer, so your team can appeal short-paid claims inside each payer’s appeal window.

Billing the Contrast Agent With 74160

74160 pays for the imaging and the contrast injection together, so no separate administration code goes on the claim. You bill the contrast agent under its own rules, and those rules change with your billing setting.

• Q9965: low osmolar contrast, 100 to 199 mg/mL iodine, per mL
• Q9966: low osmolar contrast, 200 to 299 mg/mL iodine, per mL
• Q9967: low osmolar contrast, 300 to 399 mg/mL iodine, per mL

Under OPPS, CMS packages these Q codes under status indicator N, so hospitals report them for cost data and get no separate payment. For an office or imaging center, MACs pay the Q code on its own. Commercial plans vary, and some require the National Drug Code (NDC).

Bill the Q code in milliliters, so 100 mL of a 350 mg/mL agent goes out as Q9967 with 100 units. The technique section has to name that agent, concentration, and volume, or the units won’t hold up.

Our guide to HCPCS vs CPT codes shows how the two code sets share one claim and where each one goes. Contrast supply lines go missing when someone builds a charge template without the Q code. You’ll only catch that loss in a line item payment audit.

Five 74160 Coding Scenarios, Solved

Each of these five 74160 scenarios tests a different rule behind the abdominal CT with contrast CPT code, from contrast route and scan scope to authorization and component billing.

Scenario 1: Oral Contrast Only After an IV Hold

The order reads CT abdomen with contrast, and 74160 sits in the charge queue. After a low eGFR result, the technologist held IV contrast and gave oral contrast only, and the report describes the abdomen alone.

Correct code: 74150. Oral contrast by itself doesn’t meet the CPT definition of “with contrast.” Your coder changes the queued CT abdomen CPT code to 74150 before the claim drops. Build a charge edit that flags 74160 when the technique section lists no IV agent.

Scenario 2: Abdomen Ordered, Abdomen and Pelvis Read

A gastroenterologist orders an outpatient CT abdomen with contrast, and the requisition carries 74160. The radiologist’s report covers the abdomen and pelvis with IV contrast, including a note on the bladder wall and a small pelvic fluid collection.

Correct code: 74177 as a single line, once the gastroenterologist amends the order. Update the authorization before billing, because the CPT for CT abdomen with contrast on the approval won’t match the combined code. Call the RBM the day the report posts, since plans set their own deadlines.

Scenario 3: Liver Lesion With Arterial and Portal Venous Phases

For surveillance of a known liver lesion, the patient gets a 74160 protocol with arterial and portal venous phases after one IV injection. The technologist acquires no precontrast series, and the report covers the abdomen only.

Correct code: 74160. Two contrast phases still make one study with contrast, and 74170 requires a diagnostic noncontrast series read before the injection. Protocol names like “multiphase liver” don’t settle it, so check the series list for a noncontrast pass before you move to 74170.

Scenario 4: CT Enterography Split Into Two Lines

A facility built its CT enterography protocol as 74160 plus 72193 and sent claims with both lines for months. The study imaged the abdomen and pelvis with oral and IV contrast in one session.

Correct code: 74177. The CT enterography CPT code in most protocols is 74177, since the study covers both regions with IV contrast in one session. Your compliance team should pull the unbundled claims built on that template, correct them, and return any Medicare overpayment under the 60-day rule.

Scenario 5: 74160 and 74177 on One Patient Bill

A patient calls about a statement that lists 74160 and 74177 on the same date, and the chart shows one scan. The hospital billed the technical side as 74177, and the radiology group billed 74160-26 from an old order.

Correct fix: change the professional line to 74177-26 to match the updated order. Commercial payers take a replacement claim with frequency code 7 in Box 22, while Medicare Part B needs a clerical reopening. Our guide to CMS-1500 resubmission code errors shows where Box 22 goes wrong.

Why CPT Code 74160 Claims Deny and How to Fix Each One

The claim adjustment reason codes (CARCs) below cover the 74160 denials your team will see most, and each one points to a specific fix. Correct the claim when the data was wrong, and appeal when the service was right and the payer didn’t see the proof.

Fix data errors with a corrected claim for commercial payers or a reopening for Medicare Part B. A Medicare redetermination challenges a judgment call and has to reach your MAC within 120 days of the date you receive the initial determination.

Commercial payers set their own appeal windows, so log each deadline the day the denial posts. Each month, sort 74160 denials by CARC and remittance advice remark code (RARC). Then trace the top code back to the charge entry, authorization, or coding step that created it.

If the same 74160 denials keep coming back, our denial management services team can find the step behind them and help you fix it. Older unpaid balances fit better with our accounts receivable services team, which works them by payer and appeal deadline.

What Changed for 74160 in 2026 and What Changes Next

74160 wasn’t among the 84 codes deleted in CPT 2026, and it stays active today. The dates below shape how you bill 74160 in 2026, and the October and January entries still need a spot on your team’s calendar.

• January 1, 2026: CPT 2026 took effect with 418 changes, none to 74160
• January 1, 2026: the fee schedule set 6.89 RVUs and a $230.13 national allowed amount
• October 1, 2026: FY 2027 ICD-10-CM codes and the Q4 NCCI files take effect
• October 1, 2026: Palmetto’s A56421 adds K6A.01, K6A.09, and K6A.8
• January 1, 2027: CPT 2027 takes effect with 453 changes, including 299 new codes
• January 1, 2027: the 2027 fee schedule resets the 74160 rate

The American Medical Association (AMA) lists new and revised radiology codes and a new head and neck magnetic resonance angiography table for 2027. AMA’s CPT 2027 announcement doesn’t name 74160. Check the 2027 codebook before January 1, 2027.

CMS posts the 2027 fee schedule final rule in the fall, and we’ll add the new 74160 rate here once it’s out. Until then, $230.13 stays the national allowed amount for a global claim.

CPT Code 74160 FAQs

What does the 74160 CPT code mean?

74160 reports a CT scan of the abdomen with contrast material, limited to the abdomen. The contrast has to go in through a vein or another intravascular route. If the radiologist also images the pelvis in the same session, the correct code is 74177.

Think of the code as two facts joined together, the body region and the contrast state. A change to either one changes the code, which is why coders read the technique section and the anatomy before anything else.

What is the CPT code for CT of abdomen with contrast?

74160 is the CPT code for CT of abdomen with contrast when the scan covers the abdomen alone and no diagnostic noncontrast series precedes the IV contrast. Use 74150 without contrast, 74170 for a noncontrast series followed by contrast, and 74177 when the pelvis is on the same scan.

Payers match the code to the signed report during review. An order that reads “CT abdomen” doesn’t lock in 74160 if the radiologist read more. Code from the final report, and confirm the order in the chart covers the study the report describes.

Can 74177 and 74160 be billed together?

No, 74160 and 74177 don’t pay together for the same CT session, because 74177 already includes the abdomen. NCCI lists 74177 in Column 1 and 74160 in Column 2, so Medicare denies the abdomen line. You can append XE only for a documented separate encounter on the same date.

The edit carries modifier indicator 1, which covers true separate encounters only. Appending XE to push both lines through for one scan sets up an audit finding, and a payer can recoup across the full look-back period.

Does oral contrast count as contrast for 74160?

No, oral contrast doesn’t count toward 74160. CPT radiology guidelines define “with contrast” as intravascular, intra-articular, or intrathecal contrast, so oral or rectal contrast alone codes as 74150. A study with oral contrast plus IV contrast still codes as 74160.

Oral contrast appears in most abdominal protocols, so a technique note about oral prep can mislead a new coder into choosing 74160. Look for the IV agent, its volume, and the injection time before you code.

Is CPT code 74160 still valid in 2026?

Yes, 74160 is active in 2026 with CMS status A, and CPT 2026 didn’t delete or revise it. The October 2026 fee schedule file still lists it at 6.89 total RVUs. Confirm its status in the CPT 2027 codebook before January 1, 2027.

Payers reject deleted codes for dates of service on or after January 1, so run a yearly check against the new codebook before that date. Update your charge master and EHR order sets in the same pass.

How much does Medicare pay for 74160 in 2026?

Medicare’s 2026 national allowed amount for a global 74160 is $230.13, based on 6.89 total RVUs and the $33.4009 conversion factor. The professional component pays $58.45 and the technical component pays $171.68 before your MAC’s locality adjustment. Clinicians with QP status get $231.28 at the $33.5675 factor.

Medicare pays 80% of the allowed amount after the Part B deductible, and hospital outpatient departments receive $179.20 under APC 5571 for the technical side. Ambulatory surgical centers receive $97.27 when the scan is integral to a covered procedure. Commercial plans set their own rates by contract.

Does CPT 74160 need prior authorization?

Original Medicare doesn’t require prior authorization for an outpatient 74160 study, but most Medicare Advantage and commercial plans do. The authorized CPT code has to match the code on the claim. A protocol change to 74177 needs an amended order and an updated authorization.

Run eligibility and authorization verification at scheduling, since fixing a CO-197 denial after the scan takes far more staff time than a check before it. Put the approved case number on the claim, because a missing or mismatched number draws a CO-15.

What is CPT 74160 with modifier XU?

Modifier XU on a 74160 line marks an unusual non-overlapping service, and it seldom fits a diagnostic CT. If the patient had 74160 and a bundled study at separate encounters on the same date, CMS guidance points to XE instead. Use 59 only when no X modifier fits.

Coders reach for XU because the two codes describe different studies, but CMS says different descriptors alone don’t justify an X modifier. The chart has to show a separate encounter, a separate structure, or a separate practitioner.

What is the CPT code for a CT of the kidneys with contrast?

A contrast CT of the kidneys codes as 74160, because the kidneys sit inside the abdominal field. For a renal protocol with a noncontrast series followed by contrast, the code is 74170. CT urography covering the abdomen and pelvis codes as 74178.

No separate CT kidney CPT code exists, so your coders pick among these three codes from the anatomy and contrast phases on the report. Hematuria workups point to CT urography, while renal mass characterization points to 74170.

What is the description of CPT code 74160?

The official descriptor for 74160 is “Computed tomography, abdomen; with contrast material(s).” It sits in the Diagnostic Radiology section beside 74150, without contrast, and 74170, without contrast followed by contrast. CMS shortens it to “Ct abdomen w/contrast” in fee schedule files.

Your charge master carries the full descriptor, while many practice management systems show the CMS short version on posting screens. The two short forms, “Ct abdomen w/contrast” and “Ct abd & pelvis w/contrast,” look alike on a busy screen. Train your posters to check the code itself.

Getting 74160 Claims Paid on the First Pass

Run these six checks before a 74160 claim leaves your system, and you’ll catch the errors above before a payer finds them. None of them needs new software, only a line on your charge review checklist.

1. Code from the signed report, and confirm the order covers the same study.
2. Count IV contrast only, because oral or rectal contrast alone means 74150.
3. Match 26 or TC to who owns the scanner and who reads the study.
4. Pair 74160 with a diagnosis that justifies imaging the abdomen alone.
5. Match the authorized CPT to the code on the claim.
6. Load the NCCI and MUE files for the quarter of the date of service.

If your CT abdomen with contrast CPT code claims keep coming back for the same reasons, start with a sample review. ClaimMax RCM can check your imaging claims against the signed reports and orders. Our full-service medical billing team can then help you fix the step behind the costliest denial first.

Sources

• CMS physician fee schedule relative value files, RVU26D
• CMS NCCI procedure-to-procedure edits, 2026 Q4
• CMS Medicare NCCI medically unlikely edits
• Medicare NCCI Policy Manual
• NCD 220.1, Computed Tomography
• Billing and Coding: CT of the Abdomen and Pelvis (A56421)
• Evolent Abdomen CT Clinical Guidelines, Louisiana Healthcare Connections (Louisiana Medicaid)
• Noridian JE Part B, CPT 74177 TPE review results
• Noridian JE Part B, MPPR on diagnostic imaging
• CMS CT Modifier Reduction List
• CMS MLN1783722, Proper Use of Modifiers 59, XE, XP, XS, and XU
• Medicare Benefit Policy Manual, Chapter 15, Section 80.6
• CY 2026 Physician Fee Schedule final rule, Federal Register
• CMS OPPS quarterly addenda updates
• Medicare Procedure Price Lookup, 74160
• CMS ICD-10 code files, FY 2027
• AMA releases CPT 2027 code set