CPT® Code 74262

1. Indications

CT colonography is performed for various indications related to bowel health. The following conditions or symptoms may warrant this diagnostic procedure:

• Signs of Bowel Disease Patients exhibiting symptoms such as unexplained abdominal pain, changes in bowel habits, or rectal bleeding may require evaluation through CT colonography.
• Colorectal Cancer Screening This procedure is often utilized as a screening tool for colorectal cancer, particularly in individuals at average risk or those who may be reluctant to undergo traditional colonoscopy.
• Evaluation of Polyps Patients with a history of colorectal polyps may undergo CT colonography to monitor for new or recurrent polyps.
• Assessment of Inflammatory Bowel Disease Individuals diagnosed with conditions such as Crohn's disease or ulcerative colitis may require CT colonography to assess the extent of disease and any complications.

2. Procedure

The procedure for CT colonography involves several key steps to ensure accurate imaging of the colon. The following outlines the procedural steps:

• Bowel Preparation Prior to the procedure, the patient must undergo a bowel preparation regimen the night before to clear the bowel of stool. This preparation is critical for obtaining clear and interpretable images during the CT colonography.
• Patient Positioning On the day of the procedure, the patient is positioned on the CT table, typically in a supine position. This positioning is essential for the initial imaging pass.
• Insertion of the Tube A small flexible tube is gently inserted through the anus and advanced approximately 2 inches into the rectum. This tube is used to introduce air or carbon dioxide gas into the colon.
• Colon Distension Air or carbon dioxide gas is then pumped into the colon using a manual or electronic pump. This distension is necessary to provide optimal visualization of the colon walls during imaging.
• Non-Contrast Imaging Following the distension, non-contrast CT images of the abdomen and pelvis are obtained. The patient is first scanned in the supine position, followed by a second pass in the prone position to capture comprehensive images of the colon.
• Contrast Administration In CPT® Code 74262, contrast material is injected intravenously after the non-contrast images are obtained. This step enhances the visibility of the colon and any potential abnormalities.
• Contrast Imaging Similar to the non-contrast phase, contrast images are obtained with the patient in both supine and prone positions, ensuring thorough coverage of the colon.
• Image Review and Reconstruction The obtained non-contrast and/or contrast CT images are reviewed. Three-dimensional reconstructions of the colon are created, with adjustments made as necessary to optimize visualization.
• Comparison and Reporting The physician compares the current images to any previously obtained radiological studies. After thorough analysis, a written report detailing the findings is generated for clinical use.

3. Post-Procedure

After the completion of the CT colonography, patients may experience mild discomfort due to the air or gas introduced into the colon. It is generally advised that patients resume normal activities shortly after the procedure, as it is minimally invasive. However, they should be monitored for any unusual symptoms, such as severe abdominal pain or rectal bleeding, which should prompt immediate medical attention. The physician will provide the patient with the written report of findings, which may include recommendations for further evaluation or follow-up based on the results of the imaging.