How To Use CPT Code 74190

CPT 74190 describes the peritoneogram procedure, which involves the injection of air or contrast into the peritoneal cavity to study the pattern of air in the cavity. This article will cover the description, official description, procedure, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information, similar codes and billing examples.

1. What is CPT Code 74190?

CPT 74190 is a code used to describe the peritoneogram procedure. This procedure involves injecting air or contrast into the peritoneal cavity and taking an X-ray to study the pattern of air or contrast in the cavity. It is typically performed by a radiologist or other qualified healthcare professional. The peritoneogram provides valuable diagnostic information about the peritoneal cavity and can help in the diagnosis and management of various conditions.

2. Official Description

The official description of CPT code 74190 is: ‘Peritoneogram (eg, after injection of air or contrast), radiological supervision and interpretation.’

3. Procedure

1. The patient is placed in a supine position on the procedure table.
2. Air or contrast is injected into the peritoneal cavity as a separate service.
3. A technician takes X-ray images of the peritoneum to visualize the pattern of air or contrast material.
4. The radiologist or healthcare professional supervises the technician’s work and ensures the quality of the images.
5. The radiologist reviews and interprets the images, analyzing the patterns of air or contrast to form a diagnostic conclusion.
6. The radiologist or healthcare professional writes a report with the interpretation of the images.

4. Qualifying circumstances

CPT 74190 is typically performed when there is a clinical need to study the peritoneal cavity using air or contrast. It is commonly used to evaluate conditions such as abdominal trauma, peritoneal metastasis, or suspected peritoneal infections. The procedure requires the presence of a radiologist or other qualified healthcare professional who can supervise the technician’s work and interpret the images accurately.

5. When to use CPT code 74190

CPT code 74190 should be used when performing a peritoneogram procedure, which involves injecting air or contrast into the peritoneal cavity and obtaining X-ray images to study the pattern of air or contrast. It is important to ensure that the procedure is medically necessary and supported by the patient’s clinical condition. This code should not be used for other diagnostic imaging procedures or computed tomography scans.

6. Documentation requirements

To support a claim for CPT 74190, the healthcare professional must document the following information:

• Reason for performing the peritoneogram procedure
• Type of contrast material used, if applicable
• Date and time of the procedure
• Supervision of the technician by the radiologist or healthcare professional
• Interpretation of the images, including the patterns of air or contrast
• Diagnostic conclusion and any additional recommendations

7. Billing guidelines

When billing for CPT 74190, it is important to ensure that the procedure was performed by a qualified healthcare professional and that the supervision and interpretation were provided by a radiologist or other qualified professional. It is also important to follow any specific guidelines or requirements set by the payer or insurance company. Additionally, if air or contrast material is injected separately, report the appropriate code for that service (e.g., 49400).

8. Historical information

CPT 74190 was added to the Current Procedural Terminology system on January 1, 1994. There have been no updates or changes to the code since its addition.

9. Examples

1. A radiologist performing a peritoneogram procedure to evaluate a patient with suspected peritoneal metastasis.
2. A healthcare professional injecting contrast into the peritoneal cavity and obtaining X-ray images to assess a patient with abdominal trauma.
3. A radiologist supervising a technician during a peritoneogram procedure to investigate a suspected peritoneal infection.
4. A qualified healthcare professional interpreting the images from a peritoneogram procedure to diagnose a patient with suspected peritoneal adhesions.
5. A radiologist performing a peritoneogram procedure to evaluate a patient with unexplained abdominal pain.
6. A healthcare professional injecting air into the peritoneal cavity and obtaining X-ray images to assess a patient with suspected bowel perforation.
7. A radiologist supervising a technician during a peritoneogram procedure to investigate a patient with suspected ascites.
8. A qualified healthcare professional interpreting the images from a peritoneogram procedure to diagnose a patient with suspected peritoneal dialysis complications.
9. A radiologist performing a peritoneogram procedure to evaluate a patient with suspected peritoneal carcinomatosis.
10. A healthcare professional injecting contrast into the peritoneal cavity and obtaining X-ray images to assess a patient with suspected peritoneal abscess.