Current Procedural Terminology (CPT) codes are standardized alphanumeric identifiers used across the healthcare system to describe medical, surgical, and diagnostic services. They provide a uniform language to accurately communicate what services a patient received to payers, such as insurance companies and government programs. You might encounter CPT code 70486 on a medical bill or an Explanation of Benefits (EOB) statement after undergoing a specific type of imaging procedure. These codes ensure consistency in documentation and processing of claims.
The Specific Imaging Service
CPT code 70486 identifies a Computed Tomography (CT) scan focused on three anatomical regions: the orbits, the sella turcica, and the posterior fossa. The orbits are the bony sockets that house the eyeballs, while the sella turcica is a saddle-shaped depression in the sphenoid bone that contains the pituitary gland. The posterior fossa is a small space in the skull located near the brainstem and cerebellum. This code specifies that the CT scan is performed without the use of intravenous (IV) contrast material, meaning no dye is injected. The absence of contrast distinguishes it from related procedures. Since a non-contrast CT provides excellent detail of bone structures, it is often the initial imaging choice when a condition primarily involves bone or acute issues like hemorrhage.
Clinical Reasons for the Examination
A physician orders a non-contrast CT of these regions to evaluate bony architecture or quickly rule out acute conditions. In the orbits, this scan is commonly used to assess for fractures following facial or head trauma, which can disrupt the delicate structures surrounding the eyes. It is also highly effective for detecting foreign bodies, such as metal fragments, that may be lodged in the eye socket or adjacent tissues.
For the sella turcica, a non-contrast study can reveal calcification within the pituitary gland or surrounding masses, which is a finding that influences diagnosis. While Magnetic Resonance Imaging (MRI) is often preferred for soft-tissue evaluation of the pituitary, CT is faster and superior for visualizing dense, calcified lesions. The posterior fossa is often evaluated in emergency settings to screen for acute hemorrhage, where blood appears distinctly bright on a non-contrast CT image.
What Happens During the Scan
The CT scan procedure is generally quick, non-invasive, and requires minimal preparation since no contrast material is administered. Before the scan, you will be asked to remove any metal objects, such as jewelry or hairpins, from your head and neck area, as these can interfere with image quality. You will lie on a motorized table, typically on your back, which slides into the center of the large, donut-shaped CT scanner.
The technologist will position your head carefully, sometimes using straps or a cradle to help you remain perfectly still, which is crucial for obtaining clear images. The scanner rotates around your head, using X-rays to capture multiple cross-sectional images of the targeted regions. The entire image acquisition process is usually completed within a few minutes. Because this is a non-contrast study, you will not feel the warm flushing sensation or metallic taste associated with an IV dye injection.
Understanding the Billing Context
CPT code 70486 classifies the service as a non-contrast procedure. This designation informs insurance payers that the claim is only for the imaging service itself, without the added cost of contrast material and its administration. The use of this code helps determine the appropriate reimbursement rate, which is typically lower than the codes used for scans with contrast (e.g., 70487 or 70488).
The final cost to the patient is influenced by how the insurance plan handles diagnostic imaging, which may be subject to deductibles, copayments, or coinsurance. The total charge for the procedure is often split into a “technical component” for the facility and equipment use, and a “professional component” for the radiologist’s interpretation of the images.