Radiology – Coding Guidelines & Best Practices
What is Radiology?
Radiology is a medical specialty that uses medical imaging to diagnose & treat diseases. A radiologist uses techniques such as X-ray, Computed Tomography (CT), CT Angiography (CTA), Magnetic Resonance Imaging (MRI), MR Angiography (MRA), Ultrasound, Nuclear Medicine, and Positron Emission Tomography (PET).
Components of Radiology Coding
Radiology coding is structured around three core components that define how imaging services are reported, billed, and reimbursed. Each component represents a different part of the radiology workflow — from performing the scan to interpreting the results.
1. Technical Component (TC)
The technical component includes the operational aspects of performing the imaging procedure. It covers the cost of using imaging equipment, supplies, maintenance, and the technologist’s time and expertise in capturing the images.
Modifier: –TC
2. Professional Component (PC)
The professional component accounts for the radiologist’s professional work — reviewing the images, interpreting the findings, and generating a detailed diagnostic report. This interpretation is crucial for the referring physician to make clinical decisions.
Modifier: –26
3. Global Service
When both the technical and professional components are performed and billed by the same facility or provider, it is referred to as a global service. In this case, modifiers are not needed, as the complete service is reported under one comprehensive charge.
Understanding and correctly applying these components ensures accurate billing, compliance with payer requirements, and proper distribution of reimbursement between imaging facilities and interpreting physicians.
Common Types of Radiology Procedures
Radiology encompasses several key imaging modalities, each requiring unique coding and documentation considerations:
Plain Radiography (X-Ray): Used for imaging bones, chest, and joints.
Fluoroscopy: Provides real-time moving X-ray images for dynamic studies.
Computed Tomography (CT): Produces detailed cross-sectional images of internal organs.
Ultrasound: Non-invasive imaging using sound waves to visualize soft tissues and organs.
Magnetic Resonance Imaging (MRI): Uses magnetic fields and radio waves to produce detailed images of the body’s structures.
Nuclear Medicine (NM): Involves radioactive tracers to assess organ function and physiology.
Each of these imaging techniques plays a vital role in clinical diagnosis and carries specific coding rules to ensure accurate reporting and reimbursement.
Types of Radiology CPT Code List and Ranges in 2025
Radiology services are assigned CPT (Current Procedural Terminology) codes established by the American Medical Association (AMA). Each category represents a distinct imaging type.
| Category | Description | CPT Code Range |
|---|---|---|
| Diagnostic Radiology (Imaging Studies) | Includes X-rays, CT scans, MRI, and other diagnostic imaging | 70010 – 76499 |
| Diagnostic Ultrasound | Covers general, vascular, and obstetric ultrasound procedures | 76506 – 76999 |
| Radiologic Guidance | Imaging used for guidance during procedures | 77001 – 77022 |
| Breast Imaging (Mammography) | Screening and diagnostic mammograms | 77046 – 77067 |
| Bone and Joint Imaging | Bone density and skeletal imaging studies | 77071 – 77086 |
| Radiation Oncology | Radiation therapy planning and treatment delivery | 77261 – 77799 |
| Nuclear Medicine | Functional and therapeutic nuclear imaging | 78012 – 79999 |
Radiology Documentation Requirements for Coding
Accurate and detailed documentation is the cornerstone of proper radiology coding. A complete radiology report supports medical necessity, compliance, and reimbursement accuracy.
Key Elements of a Radiology Report
Anatomical site or body area imaged
Laterality (right, left, or bilateral)
Imaging technique (CT, MRI, Ultrasound, etc.)
Contrast information — without, with, or both
Clinical indication or reason for the study
Radiologist’s findings, interpretation, and impression
Incomplete documentation can lead to denials, underpayments, and audit risks, making it essential to capture all report details.
Radiology Coding Guidelines and Best Practices
Radiology coding requires precision and compliance with both CPT and payer-specific rules. The following guidelines help coders maintain accuracy and efficiency.
Apply Correct Modifiers
–26: Professional component
–TC: Technical component
–59: Distinct procedural service
–76 / –77: Repeat procedures
Link CPT Codes with ICD-10-CM Diagnoses
Each imaging study must be supported by a diagnosis that demonstrates medical necessity.Understand Bundled Services
Certain studies, such as CT abdomen and pelvis, may need to be billed as a single combined service.Follow NCCI Edits
Use National Correct Coding Initiative (NCCI) guidelines to prevent unintentional unbundling.Conduct Regular Audits
Internal audits help identify documentation gaps and coding inconsistencies early.Stay Updated Annually
Review the latest CPT and CMS updates every year to ensure compliance and accurate reporting.
Following these practices helps maintain compliance and supports smooth revenue cycle operations in radiology departments.
Trends in Radiology and Coding
The field of radiology is evolving rapidly with advances in digital imaging, AI integration, and automated reporting tools. Hybrid modalities such as PET/MRI and 3D mammography are expanding clinical capabilities and adding new CPT codes.
Artificial intelligence now assists in image interpretation, report generation, and even code validation, helping reduce manual errors and increase workflow efficiency.
Coders are also adapting to digital transformation, learning to manage data from PACS (Picture Archiving and Communication Systems) and electronic health records (EHRs) for more integrated reporting.
Staying informed about these changes ensures coders remain compliant, efficient, and aligned with the future of medical imaging.
Conclusion
Radiology coding connects cutting-edge imaging technology with the administrative accuracy needed for effective healthcare delivery. It ensures every diagnostic image, interpretation, and report is properly documented, billed, and reimbursed. By mastering radiology CPT codes, maintaining precise documentation, and following best practices, medical coders play a vital role in improving both clinical outcomes and operational efficiency.
As radiology continues to evolve, accurate and informed coding will remain fundamental to patient care, compliance, and the success of healthcare organizations.
