ICD-10-PCS Billable Code

BQ24ZZZ

Computerized Tomography (CT Scan) Femur, Left to None with None, None Approach

Procedural Specifications

Clinical Axis Detail Definition
SectionB Imaging
Body SystemQ Non-Axial Lower Bones
Operation2 Computerized Tomography (CT Scan)
Body Part4 Femur, Left
ApproachZ None
DeviceZ None
QualifierZ None

Operation Definition

Computer reformatted digital display of multiplanar images developed from the capture of multiple exposures of external ionizing radiation

Procedure Overview

This family covers computed tomography of the non-axial lower bones, including the femur, patella, tibia, fibula, tarsal and metatarsal bones, and the hip, knee, ankle, and foot joints. The scanner rotates around the limb, taking many individual x-ray exposures from different angles, and a computer reconstructs them into detailed cross-sectional slices that can be viewed in multiple planes or rendered as a three-dimensional model. This level of detail makes it well suited to complex bone injuries and anatomy that plain film alone cannot fully characterize.

Providers order this study for comminuted or intra-articular fractures where surgical planning requires a precise map of fragment position, for suspected bone tumors or infections where the extent of involvement needs to be defined, and for evaluating complicated foot and ankle trauma where overlapping bones make plain films hard to interpret. It is also used post-operatively to confirm hardware placement or check for nonunion of a healing fracture. Because it involves a higher radiation dose than a plain film, it is generally reserved for cases where that added detail changes management.

Anatomy & Axis Detail

Femur, Left

This procedure captures cross-sectional imaging of the left femur, the body's largest long bone, allowing detailed characterization of fracture patterns, cortical integrity, and any suspected bony lesion along its shaft or metaphysis. Because femoral fractures frequently result from high-energy trauma, CT is valuable for surgical planning when comminution or intra-articular extension near the hip or knee needs precise delineation. It is also used to evaluate the extent of osteomyelitis or to characterize a bone tumor's margins and any associated soft tissue involvement. The left side should be clearly documented, along with the specific segment imaged, since findings and subsequent treatment may be localized to the proximal, midshaft, or distal femur rather than the entire bone.

Coding & Documentation

Assigning the code correctly depends on identifying the exact body part scanned from the radiology report, since hip, knee, ankle, and foot each have their own value, and orders written broadly as "leg CT" should be checked against what the radiologist actually documented. The report should indicate whether contrast material was administered, which affects the qualifier selected, and whether the study covered one limb or both. A common documentation gap is a report that discusses reconstructed three-dimensional images without clearly stating the primary body part scanned, which can lead to selecting the wrong region or missing a bilateral component.

Commonly Confused With

This family is often confused with MRI of the same lower bone region, since both can be ordered to evaluate complex fractures or tumors, but CT relies on multiple x-ray exposures reconstructed by computer while MRI uses a magnetic field and radiofrequency signals with no ionizing radiation. It is also distinguished from plain radiography and fluoroscopy of the lower bones, both of which use simpler forms of x-ray capture without the cross-sectional, computer-reconstructed detail that defines a CT study.