Radiology Question for the Week of February 20, 2017



We are going to begin offering CT Colonography at our facility. I’ve found CPT code 74261–74263 for the procedure, but I can’t find anything for Tagitol™ V (Barium Sulfate Suspension 40% w/v, 30% w/w) Stool Tagging Agent that we will be giving the patient to take the day before. Can you tell me what code to use?



Tagitol V is a barium sulfate suspension. There are no specific HCPCS codes for barium products as Medicare specifically lists barium as an example of a drug that is treated as a supply (Medicare Benefit Policy Manual, chapter 15, section 50.2.M). If you choose, you could report it for tracking purposes under revenue code 255 (drugs incident to radiology) or 621 (medical/surgical supplies incident to radiology).

For the computed tomographic colonography (CTC) itself, report the following code for a diagnostic exam without IV contrast material:

74261 CTC, diagnostic, including image post-processing; without contrast material

For a diagnostic exam with IV contrast material, report the following, which includes any non-contrast images performed in addition to the contrast imaging:

74262 CTC, diagnostic, including image post-processing; with contrast material(s) including non-contrast images, if performed

If intravenous contrast is used, also report the appropriate HCPCS code for the contrast material.

For Isovue®-200 (Iopamidol Injection 41%) or Isovue®-250 (Iopamidol Injection 51%), report code Q9966—low osmolar contrast material [LOCM], 200–299 mg/mL iodine concentration, per mL

For Isovue®-300 (Iopamidol Injection 61%) or Isovue®-370 (Iopamidol injection 76%) report code Q9967—LOCM, 300–399 mg/mL iodine concentration, per mL

A screening CTC would be reported with code 74263—CTC, screening, including image post-processing.

All three of these CPT codes (74261, 74262, 74263) include 3D post processing. It would be inappropriate to also report 76376 or 76377.

76376 3D rendering with interpretation and reporting of computed tomography, MRI, ultrasound, or other tomographic modality with image post-processing under concurrent supervision; not requiring image post-processing on an independent workstation
76377 requiring image post-processing on an independent workstation

Tagitol™ V (Barium Sulfate Suspension 40% w/v, 30% w/w) Stool Tagging Agent

Indications and Usage:
Tagitol V is a low-volume radiopaque marker that blends into stool as it forms. With just a 20 mL dose with breakfast, lunch and dinner the day prior to the exam, Tagitol V provides immediate, visible identification of retained feces via comparative density analysis, simplifying the distinction between tagged feces and colonic abnormality.

For use in opacifying residual stool in the colon during CTC. This product should not be used in patients with known or suspected gastric and intestinal perforation, or hypersensitivity to barium sulfate or any component of this barium sulfate formulation. Rarely, severe and occasionally fatal allergic reactions have been reported following administration of barium sulfate contrast agents.

Please see full Prescribing Information for Tagitol V by clicking here.

You are encouraged to report negative side effects of prescription drugs to the FDA. Visit or call 1-800-FDA-1088.

Manufactured by E-Z-EM Canada Inc., for E-Z-EM, Inc., a subsidiary of Bracco Diagnostics Inc., Monroe Twp., NJ 08831.

Tagitol is a trademark of E-Z-EM, Inc.


ISOVUE® (Iopamidol Injection)

ISOVUE®-200 (Iopamidol Injection 41%)
ISOVUE®-250 (Iopamidol Injection 51%)
ISOVUE®-300 (Iopamidol Injection 61%)
ISOVUE®-370 (Iopamidol injection 76%)

Indications and Usage:

Isovue-200, 250, 300, 370
Isovue is indicated for angiography throughout the cardiovascular system, including cerebral and peripheral arteriography, coronary arteriography and ventriculography, pediatric angiocardiography, selective visceral arteriography and aortography, peripheral venography (phlebography), and adult and pediatric intravenous excretory urography and intravenous adult and pediatric contrast enhancement of computed tomographic (CECT) head and body imaging.

Isovue IS NOT FOR INTRATHECAL USE. Iopamidol Injection is available as Isovue-M® for intrathecal administration.

Nonionic iodinated contrast media inhibit blood coagulation, in vitro, less than ionic contrast media. Clotting has been reported when blood remains in contact with syringes containing nonionic contrast media. Serious, rarely fatal, thromboembolic events causing myocardial infarction and stroke have been reported during angiographic procedures with both ionic and nonionic contrast media. Therefore, meticulous intravascular administration technique is necessary, particularly during angiographic procedures, to minimize thromboembolic events.

As with all injectable contrast agents, the possibility of severe reactions should be borne in mind, regardless of the patient’s pre-existing medical history. As with any other iodinated contrast media, caution must be exercised in patients with severely impaired renal function, combined renal and hepatic disease, combined renal and cardiac disease, severe thyrotoxicosis, myelomatosis, or anuria, particularly when large doses are administered.

Please see full Prescribing Information.

You are encouraged to report negative side effects of prescription drugs to the FDA. Visit or call 1-800-FDA-1088.

Isovue and Isovue-M are currently manufactured for Bracco Diagnostics Inc. at two locations: BIPSO GmbH, Singen (Germany) and Patheon Italia S.p.A., Ferentino (Italy).

Isovue and Isovue-M are registered trademarks of Bracco Diagnostics Inc