How To Use CPT Code 74328

CPT 74328 describes the radiological supervision and interpretation for endoscopic catheterization of the biliary ductal system. This article will cover the description, official details, procedure, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information, similar codes and billing examples.

1. What is CPT Code 74328?

CPT 74328 is used to report the radiological supervision and interpretation for endoscopic catheterization of the biliary ductal system. This procedure involves the insertion of an endoscope into the bile ducts to visualize and assess any abnormalities or conditions. The provider administers contrast and uses fluoroscopy to guide the procedure and obtain images of the ducts. CPT 74328 represents only the imaging supervision and interpretation for this specific procedure.

2. Official Description

The official description of CPT code 74328 is: ‘Endoscopic catheterization of the biliary ductal system, radiological supervision and interpretation.’

3. Procedure

1. The provider guides an endoscope through the patient’s mouth, throat, stomach, and small intestine or duodenum.
2. Using fluoroscopy, the provider locates the opening to the biliary ducts and advances a guide wire into the opening.
3. A flexible tube is then inserted into the bile duct, and contrast is administered.
4. The provider uses a video monitor to view and assess the images of the ducts, looking for any abnormalities or structural malformations.
5. The provider performs the necessary radiological supervision and interpretation during the procedure.

4. Qualifying circumstances

CPT 74328 is used when the provider performs radiological supervision and interpretation for the endoscopic catheterization of the biliary ductal system. This procedure is typically performed to assess the presence of tumors, strictures, stones, or other abnormal formations in the biliary ducts. The provider must have the necessary expertise and equipment to perform the procedure and interpret the obtained images.

5. When to use CPT code 74328

CPT code 74328 should be used when the provider performs the radiological supervision and interpretation for the endoscopic catheterization of the biliary ductal system. It is important to note that this code represents only the imaging component of the procedure and should not be reported if the provider also performs other services related to the endoscopic catheterization.

6. Documentation requirements

To support a claim for CPT 74328, the provider must document the following information:

• Indication for the procedure and the medical necessity of radiological supervision and interpretation
• Details of the procedure, including the use of contrast and fluoroscopy
• Images obtained and their interpretation
• Any abnormalities or findings observed during the procedure
• Signature of the provider performing the radiological supervision and interpretation

7. Billing guidelines

When billing for CPT 74328, ensure that the provider is performing the radiological supervision and interpretation for the endoscopic catheterization of the biliary ductal system. This code should not be reported if the provider is also performing other services related to the procedure. It is important to follow payer guidelines and modifiers, such as modifier 26 for the professional component and modifier TC for the technical component, if applicable.

8. Historical information

CPT 74328 was added to the Current Procedural Terminology system on January 1, 1990. There have been no updates or changes to the code since its addition.

9. Examples

1. A gastroenterologist performs radiological supervision and interpretation for the endoscopic catheterization of the biliary ductal system to assess the presence of stones in a patient with suspected gallstones.
2. A radiologist guides an endoscope into the bile ducts and administers contrast to visualize and assess any strictures or abnormalities in a patient with suspected biliary obstruction.
3. A hepatologist performs the radiological supervision and interpretation for the endoscopic catheterization of the biliary ductal system to evaluate the presence of tumors in a patient with suspected liver cancer.
4. An interventional radiologist uses fluoroscopy to guide the insertion of a tube into the bile ducts and performs the necessary radiological supervision and interpretation to assess the presence of structural malformations in a patient with congenital biliary abnormalities.
5. A gastrointestinal surgeon performs radiological supervision and interpretation for the endoscopic catheterization of the biliary ductal system to evaluate the effectiveness of a previous biliary stent placement in a patient with recurrent biliary strictures.