How To Use CPT Code 74329

CPT 74329 describes the radiological supervision and interpretation for endoscopic catheterization of the pancreatic ductal system. This article will cover the description, procedure, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information, similar codes and billing examples.

1. What is CPT Code 74329?

CPT 74329 can be used to represent the radiological supervision and interpretation for endoscopic catheterization of the pancreatic ductal system. This code is used when a provider performs imaging supervision and interpretation for a separately reportable procedure involving the insertion of an endoscope into the pancreatic ducts. The provider administers contrast and uses fluoroscopy to view the duct contents and assess for any abnormalities.

2. Official Description

The official description of CPT code 74329 is: ‘Endoscopic catheterization of the pancreatic ductal system, radiological supervision and interpretation.’

3. Procedure

1. The provider guides an endoscope through the mouth and stomach to the small intestine or duodenum, and through the duodenal loop.
2. Using fluoroscopy, the provider advances a guide wire into the opening of the bile ducts that empty from the liver and pancreas.
3. A flexible tube is then placed into the pancreatic duct, and contrast is injected.
4. The provider views images of the ducts on a video monitor to assess them and identify or confirm any structural malformations, stones, or other abnormalities.

4. Qualifying circumstances

CPT 74329 is used when a provider performs radiological supervision and interpretation for endoscopic catheterization of the pancreatic ductal system. This procedure is typically performed on patients who require assessment of the pancreatic ducts for tumors, strictures, stones, or other abnormal formations. The provider must administer contrast and use fluoroscopy to guide the procedure.

5. When to use CPT code 74329

CPT code 74329 should be used when a provider performs radiological supervision and interpretation for endoscopic catheterization of the pancreatic ductal system. This code represents the imaging component of the procedure and should be reported separately from the endoscopic procedure itself.

6. Documentation requirements

To support a claim for CPT 74329, 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
• Findings from the imaging, including any abnormalities or structural malformations
• Signature of the provider who performed the radiological supervision and interpretation

7. Billing guidelines

When billing for CPT 74329, ensure that the provider performing the radiological supervision and interpretation is appropriately qualified. This code should be reported separately from the endoscopic procedure itself. If the radiological supervision and interpretation are performed by different providers, each provider should report the code with reduced service modifier 52 and append modifier 26 to represent only the professional component. If reporting only the technical component, append modifier TC to the code.

8. Historical information

CPT 74329 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 gastroenterologist performing radiological supervision and interpretation for endoscopic catheterization of the pancreatic ductal system to assess for pancreatic tumors.
2. An interventional radiologist guiding the insertion of an endoscope into the pancreatic ducts and administering contrast to view the duct contents for the presence of stones.
3. A radiologist using fluoroscopy to guide the placement of a flexible tube into the pancreatic duct and injecting contrast to assess for any structural malformations.
4. A hepatologist interpreting the images obtained from endoscopic catheterization of the pancreatic ductal system to confirm the presence of a stricture.
5. An oncologist reviewing the radiological images of the pancreatic ducts to identify any abnormalities or tumors.
6. A gastrointestinal surgeon performing radiological supervision and interpretation for endoscopic catheterization of the pancreatic ductal system to assess for any narrowing or strictures.
7. A radiology resident assisting in the fluoroscopic visualization of the pancreatic ducts during endoscopic catheterization.
8. A nurse practitioner documenting the findings from the radiological images obtained during endoscopic catheterization of the pancreatic ductal system.
9. A radiology technician preparing the contrast material for injection during the procedure.
10. A medical coder assigning the appropriate CPT code for the radiological supervision and interpretation component of the endoscopic catheterization procedure.