Practice Management

"CT Urogram" really shouldn't be an ordering option.  Everyone, from the ordering physician to the tech to the radiologist should be using the proper terminology for what is actually wanted and being done.  CT urogram is a protocol and not CPT terminology.  And different facilities have different protocols for what they consider CT urogram.

You also need to clarify the facility's protocol.  I see places billing a "with contrast" CT when the only contrast given is through a bladder catheter, not IV.

If everybody insists on using the protocol terminology then you should have a written policy stating what your facility's protocol is, have everybody sign it, and never vary from it.

Here's what the AMA and ACR say in Clinical Examples in Radiology, Spring 2018:

The Spring 2007 issue of Clinical Examples in Radiology states, "The use of the term CT urogram in the report is misleading. CT codes were developed to be anatomic-site specific; therefore, physicians are urged to use the proper nomenclature in their reports when describing the procedures performed. Because CT studies are previewed and tailored to the clinical indications at hand, the reporting of such studies termed as CT urography, CT cystography, or CT enterography will vary from practice to practice. Protocols will stipulate what anatomical areas need to be imaged in order to answer the clinical question at hand." In the case of a CT urogram protocol that uses pre- and post-intravenous contrast imaging of both the abdomen and pelvis, an example of a procedure description that would adequately capture the relevant clinical information for coding purposes would be "CT scan of the abdomen and pelvis was performed before and after the administration of IV contrast material."