Computed tomography, head or brain; without contrast material
Audit Defense & Denial Intelligence
Research-based denial patterns from OrbDoc Bill Analyzer
1. CT head medical necessity criteria not met or red flag symptoms not documented
Very Common70450 (CT head/brain without contrast) requires specific clinical indication with concerning features. Denied when ordered for simple headache without red flags, when neurologic exam normal and symptoms chronic, or when indication doesn't warrant imaging. Red flags requiring CT: acute severe headache (worst ever), trauma, altered mental status, new focal neurologic deficit, suspected stroke, headache with fever.
Common Causes
- • Chronic headache pattern without change - stable migraines don't require repeat imaging
- • No red flag symptoms documented - simple headache insufficient indication
- • Normal neurologic exam with non-specific symptoms - low likelihood of positive finding
Resolution Strategy
Document red flag features: 'Patient with sudden-onset severe headache 2 hours ago, described as "worst headache of my life" while exercising. Associated neck stiffness and photophobia. Alert but uncomfortable. Neurologic exam: subtle right facial droop, otherwise intact. CT head ordered emergently to rule out subarachnoid hemorrhage, intracranial hemorrhage, or acute stroke.' Must include: acute onset, severity, red flag symptoms (sudden severe, worst ever, thunderclap, with trauma, with neurologic findings, with fever/neck stiffness), time course. If chronic stable headache with normal exam, not medically necessary. Cannot appeal without documented red flags.
💬 Plain Language Explanation
What this means
This is a CT scan of your head (brain) - a detailed imaging test that uses X-rays to create cross-sectional pictures of your brain.
Why you might see this
This is a common imaging test for head or brain problems. Your doctor likely ordered this to check for brain injuries, tumors, bleeding, or other brain conditions. CT scans are often used in emergency situations.
Common context
Common imaging test for diagnosing brain conditions, often used in emergency situations.
What to ask your provider
"'What did the CT scan show? Are there any problems with my brain?'"
Relative Value Units (RVUs)
Calculator →
Clinical Information
When to Use
For CT head or brain without contrast material
Common Scenarios
Documentation Requirements
- Indication for CT head/brain
- Without contrast
- Findings and interpretation
- Comparison to prior studies if available
- Report documentation
Coding Guidelines
Common Modifiers
Bundling Rules
- Includes CT head/brain without contrast
- Includes interpretation and report
- With contrast coded separately
- With and without contrast coded separately
- Follow-up CT coded separately
Exclusions
- 70460 (CT head or brain with contrast)
- 70470 (CT head or brain without contrast followed by contrast)
- 70480 (CT orbit, sella, or posterior fossa without contrast)
- 70551 (MRI brain without contrast)
Coding Notes
Clinical scenarios
- Indication for CT head/brain
- Without contrast
- Findings and interpretation
- Indication for CT head/brain
- Without contrast
- Findings and interpretation
- Indication for CT head/brain
- Without contrast
- Findings and interpretation
Who are you?
Code Details
Medicare Pricing
PFSRVU Breakdown
OPPS Details
Automate Coding
Let OrbDoc AI automatically suggest codes from your clinical notes.
Patient? Check your bill.
Use our free analyzer to understand charges and spot errors.
Analyze My BillAsk OrbDoc AI
Get instant answers about 70450 - pricing, bundling rules, or billing questions.
Ask a QuestionFrequently Asked Questions
CPT 70450 is the billing code for "Computed tomography, head or brain; without contrast material". For CT head or brain without contrast material
Medicare pays approximately $105.13 for CPT 70450 (national average). Actual payment varies by geographic location due to GPCI adjustments. Hospital and commercial insurance rates are typically 2-4x higher than Medicare rates.
CPT 70450 has a total RVU of 9.82, broken down as: Work RVU 1.20, Practice Expense RVU 8.50, and Malpractice RVU 0.12. RVUs (Relative Value Units) determine Medicare reimbursement rates.
The most common denial reason for CPT 70450 is "CT head medical necessity criteria not met or red flag symptoms not documented". 70450 (CT head/brain without contrast) requires specific clinical indication with concerning features. Denied when ordered for simple headache without red flags, when neurologic exam normal and symptoms chronic, or when indication doesn't warrant imaging. Red flags requiring CT: acute severe headache (worst ever), trauma, altered mental status, new focal neurologic deficit, suspected stroke, headache with fever. Common causes include: Chronic headache pattern without change - stable migraines don't require repeat imaging; No red flag symptoms documented - simple headache insufficient indication. Appeal success rate is approximately 40-60%.
Key documentation requirements for CPT 70450 include: Indication for CT head/brain; Without contrast; Findings and interpretation; Comparison to prior studies if available. Missing or incomplete documentation is a leading cause of claim denials for this code.
Bundling considerations for CPT 70450: Includes CT head/brain without contrast. Includes interpretation and report Use an NCCI bundling checker to verify specific code combinations before billing.
Common modifiers for CPT 70450 include: 26 (Professional component only (interpretation)), TC (Technical component only (equipment/staff)), 59 (Distinct procedural service if performed separately). Modifiers indicate special circumstances and can affect reimbursement or prevent claim denials.
The typical time requirement for CPT 70450 is 15-20 minutes typical procedure time. Time-based codes require documentation of the actual time spent providing the service.