How To Use CPT Code 74300

CPT 74300 describes the radiological supervision and interpretation of cholangiography and/or pancreatography performed intraoperatively. 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 74300?

CPT 74300 can be used to represent the radiological supervision and interpretation of cholangiography and/or pancreatography performed intraoperatively. This code is used when a provider injects a radiocontrast material into the patient’s common bile duct during surgery to help detect stones, tumors, or strictures. The provider then performs imaging supervision and interpretation to examine the biliary tract, gallbladder, pancreatic ducts, and duodenum.

2. Official Description

The official description of CPT code 74300 is: ‘Cholangiography and/or pancreatography; intraoperative, radiological supervision and interpretation.’

3. Procedure

1. The patient is appropriately prepped and anesthetized for surgery.
2. The provider performs radiological supervision during a separately reportable operative procedure, such as gallbladder surgery.
3. The provider places a catheter into the bile ducts under fluoroscopy and injects a radiocontrast material directly into the ducts.
4. The provider takes images to detect calculi or stones and visualize the anatomy of the bile ducts, gallbladder, pancreatic ducts, and duodenum.

4. Qualifying circumstances

CPT 74300 is used when the provider performs radiological supervision and interpretation of cholangiography and/or pancreatography during surgery. This procedure helps detect stones, tumors, or strictures in the biliary tract. It is important to note that this code represents only the imaging supervision and interpretation for this procedure.

5. When to use CPT code 74300

CPT code 74300 should be used when a provider performs radiological supervision and interpretation of cholangiography and/or pancreatography during surgery. It should not be used for other diagnostic radiology procedures or when the imaging is performed outside of an intraoperative setting.

6. Documentation requirements

To support a claim for CPT 74300, the provider must document the following information:

• Details of the surgical procedure performed
• Specific findings observed during the cholangiography and/or pancreatography
• Images obtained during the procedure
• Signature of the provider performing the radiological supervision and interpretation

7. Billing guidelines

When billing for CPT 74300, ensure that the provider is performing radiological supervision and interpretation during a separately reportable operative procedure. It is important to note that Medicare does not pay hospitals separately for supervision and interpretation codes deemed to be ancillary and supportive services to primary diagnostic or therapeutic services. However, the code should still be reported for statistical purposes.

8. Historical information

CPT 74300 was added to the Current Procedural Terminology system on January 1, 1990. There have been no updates to the code since its addition.

9. Examples

1. A surgeon performing radiological supervision and interpretation of cholangiography during a laparoscopic cholecystectomy.
2. A radiologist overseeing the imaging and interpretation of pancreatography during an open exploration of the common duct.
3. A gastroenterologist providing radiological supervision and interpretation of cholangiography and pancreatography during a surgical procedure to remove stones from the biliary tract.
4. An interventional radiologist performing radiological supervision and interpretation of cholangiography and pancreatography during a procedure to place a stent in the bile duct.
5. A hepatobiliary surgeon overseeing the imaging and interpretation of cholangiography and pancreatography during a liver resection surgery.
6. A general surgeon performing radiological supervision and interpretation of cholangiography during a procedure to repair a bile duct stricture.
7. An endoscopist providing radiological supervision and interpretation of pancreatography during an endoscopic retrograde cholangiopancreatography (ERCP) procedure.
8. A surgical oncologist overseeing the imaging and interpretation of cholangiography and pancreatography during a procedure to remove a tumor from the pancreas.
9. A hepatologist performing radiological supervision and interpretation of cholangiography and pancreatography during a liver transplant surgery.
10. An interventional radiologist providing radiological supervision and interpretation of cholangiography and pancreatography during a procedure to drain a pancreatic pseudocyst.