How To Use CPT Code 74330

CPT 74330 describes the combined endoscopic catheterization of the biliary and pancreatic ductal systems, with radiological supervision and interpretation. 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 74330?

CPT 74330 is used to describe a procedure in which the provider performs imaging supervision and interpretation for a separately reportable endoscopic duct catheterization. This involves the insertion of an endoscope into the bile and pancreatic ducts, followed by the administration of contrast and the use of a fluoroscope to view the duct contents. The purpose of this procedure is to check for tumors, strictures, stones, or other abnormalities in the ducts.

2. Official Description

The official description of CPT code 74330 is: ‘Combined endoscopic catheterization of the biliary and pancreatic ductal systems, 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 opening, and contrast is injected.
4. The provider views images of the pancreatic and bile ducts on a video monitor to assess them and identify any structural malformations, stones, or other abnormalities.

4. Qualifying circumstances

CPT 74330 is performed when a provider performs radiological supervision and interpretation for a combined endoscopic catheterization of the biliary and pancreatic ductal systems. This procedure is typically done to assess the structures of the ducts and identify any abnormalities or conditions that may require further treatment or intervention.

5. When to use CPT code 74330

CPT code 74330 should be used when a provider performs the combined endoscopic catheterization of the biliary and pancreatic ductal systems and provides radiological supervision and interpretation. This code should be reported for the imaging component of the procedure.

6. Documentation requirements

To support a claim for CPT 74330, the provider must document the following information:

• Indication for the procedure
• Details of the endoscopic catheterization, including the specific structures assessed and any abnormalities identified
• Date and time of the procedure
• Contrast used, if applicable
• Images obtained and findings
• Signature of the provider performing the imaging supervision and interpretation

7. Billing guidelines

When billing for CPT 74330, ensure that the provider is performing the combined endoscopic catheterization of the biliary and pancreatic ductal systems and providing radiological supervision and interpretation. This code should not be reported if the related endoscopic retrograde cholangiopancreatography or esophagogastroduodenoscopy codes (43260-43278) are already reported. Modifier 52 should be appended if one provider supervises the radiology service and another provider interprets it. Modifier 26 should be appended to report only the professional component, and modifier TC should be appended to report only the technical component, if applicable.

8. Historical information

CPT 74330 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 performs CPT 74330 to assess the biliary and pancreatic ducts for the presence of stones in a patient with suspected gallstones.
2. A radiologist provides imaging supervision and interpretation for a combined endoscopic catheterization of the biliary and pancreatic ductal systems to evaluate a patient with suspected pancreatic cancer.
3. An interventional radiologist performs CPT 74330 to assess the biliary and pancreatic ducts for strictures in a patient with recurrent episodes of jaundice.
4. A hepatologist performs imaging supervision and interpretation for a combined endoscopic catheterization of the biliary and pancreatic ductal systems to evaluate a patient with suspected biliary obstruction.
5. A general surgeon performs CPT 74330 to assess the biliary and pancreatic ducts for abnormalities in a patient with unexplained abdominal pain.
6. An interventional radiologist provides imaging supervision and interpretation for a combined endoscopic catheterization of the biliary and pancreatic ductal systems to evaluate a patient with suspected pancreatitis.
7. A gastroenterologist performs CPT 74330 to assess the biliary and pancreatic ducts for the presence of tumors in a patient with abnormal liver function tests.
8. A radiologist provides imaging supervision and interpretation for a combined endoscopic catheterization of the biliary and pancreatic ductal systems to evaluate a patient with suspected choledocholithiasis.
9. An interventional radiologist performs CPT 74330 to assess the biliary and pancreatic ducts for strictures in a patient with a history of chronic pancreatitis.
10. A hepatologist performs imaging supervision and interpretation for a combined endoscopic catheterization of the biliary and pancreatic ductal systems to evaluate a patient with suspected biliary dyskinesia.